Pregnancy complicated with low-grade appendiceal mucinous tumor: A case report

Low-grade appendiceal mucinous neoplasm (LAMN) is a rare neoplastic entity, especially during pregnancy. Early prenatal detection remains exceedingly rare, and no consensus exists regarding the optimal timing or strategy for surgical intervention during pregnancy.

A 31-year-old pregnant woman at 27 weeks of gestation presented with mild abdominal pain accompanied by diarrhea. Routine prenatal ultrasonography identified a cystic mass in the right lower quadrant of the abdomen, measuring 76 × 21 × 26 mm, exhibiting the characteristic "onion skin sign."

Prenatal ultrasonography raised suspicion of LAMN. Follow-up imaging and definitive histopathological evaluation following surgical resection confirmed the diagnosis of LAMN.

Given the patient's stable condition and lack of symptom progression, the multidisciplinary team elected to pursue expectant management with serial ultrasonography. At 40 weeks of gestation, she underwent an elective cesarean section, followed by an appendectomy and partial ileocecal resection. Surgery was performed with precautions to prevent mucinous dissemination.

Histopathological analysis confirmed LAMN in the absence of rupture or peritoneal dissemination. The patient experienced an uneventful postoperative recovery, and both mother and infant remained in good health throughout 12 months of follow-up, with no radiological or clinical evidence of recurrence.

This case highlights the feasibility of accurate prenatal diagnosis of LAMN via ultrasonography and emphasizes the importance of multidisciplinary management in optimizing maternal-fetal outcomes. Expectant management until full-term delivery, followed by coordinated surgical intervention, may represent a safe and effective approach in selected cases of pregnancy complicated by LAMN.