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[Appendiceal mucoceles. Pathophysiology and therapeutic indications]
M Scotté1, A Laquerrière, Y Riff
1Service de Chirurgie Générale et Digestive, Hôpital Charles-Nicolle, Rouen.
Journal De Chirurgie
|June 1, 1994
Summary
Appendiceal mucoceles (AM) are rare appendix lesions caused by obstruction or tumors. Treatment varies by type, with retention AMs treated by appendectomy and malignant forms requiring hemicolectomy.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Oncology
Background:
- Appendiceal mucoceles (AM) are uncommon appendix lesions characterized by mucus accumulation.
- Pathogenesis involves appendiceal lumen obstruction or neoplastic (benign/malignant) or non-neoplastic hypersecretion.
- Perforation, particularly of malignant AM, can lead to intraperitoneal mucinous effusion (IME).
Purpose of the Study:
- To investigate the pathogenic mechanisms, clinical presentation, and treatment outcomes of appendiceal mucoceles.
- To differentiate between retention AM and neoplastic AM.
- To evaluate the prognostic factors associated with different types of AM.
Main Methods:
- Retrospective analysis of 13 cases of appendiceal mucoceles.
- Review of clinical symptoms, paraclinical investigations, and surgical findings.
- Histopathological examination to determine the nature of the AM and associated lesions.
Main Results:
- 13 retention AMs were identified, mostly associated with obstructive lesions.
- 3 malignant AMs (cystadenocarcinomas) were found, all linked to neoplastic IME.
- No benign cystadenomas were observed in this series.
- Preoperative diagnosis was achievable through paraclinical investigations despite confusing clinical symptoms.
Conclusions:
- Retention AMs, often caused by obstruction, are treated with appendectomy with a good prognosis.
- Malignant AMs (cystadenocarcinomas) necessitate right hemicolectomy and have a poor prognosis.
- Appendiceal mucocele management and prognosis depend on the underlying cause and presence of malignancy.