Giant Appendicular Mucocele Due to Mucinous Cystadenoma
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Abstract:
Mucocele of the appendix is a rare clinicopathological entity simulating acute appendicitis. The most common form of the mucocele is cystadenoma, which is characterized by luminal dilatation producing large amounts of mucin. We present a new case of a giant mucocele of appendix with mucinous cystadenoma. A 61-year-old female was admitted with complaints of severe lower right quadrant pain. Ultrasonography and computed tomography (CT) suggested that it was a mucocele, but due to severity of pain, she underwent an emergency operation. Fortunately, without a perforation, it was a giant mucocele and the operation was terminated with an uneventful appendectomy with segmental cecal resection. The histopathological evaluation of the specimen reported to be a mucocele with mucinous cystadenoma with negative surgical margins. The patient was discharged postoperative 6th day, and a control colonoscopy and abdominal CT was planned for 6 months following surgery. Appendicular mucocele is rare and difficult to diagnose preoperatively, and sometimes it may be of large size which increases the risk of perforation. Pseudomyxoma peritonei (PP) is the most feared complication of mucocele perforation. Appendectomy with negative margins is a requirement for adequate treatment for most cases. Utmost care should be taken during surgery to avoid perforation of mucocele.Sertkaya M, Emre A, Pircanoglu EM, Peker O, Cengiz E, Karaagaç M. Giant Appendicular Mucocele Due to Mucinous Cystadenoma. Euroasian J Hepato-Gastroenterol 2016;6(2):186-189.Keywords:
Mucocele
Mucinous cystadenoma
Pseudomyxoma Peritonei
Perforation
Cystadenoma
Pseudomyxoma Peritonei
Mucinous cystadenoma
Surgical oncology
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Mucocele of the appendix is a rare lesion, characterized by distension of the lumen due to accumulation of mucus material. Correct preoperative diagnosis is seldom achieved. If left untreated, the mucocele may rupture producing a potentially fatal peritoneal spread. The type of surgical treatment is related to the dimensions and histology of the mucocele. In this paper, the case of a 49-year-old woman, with a previous appendectomy, suffering from a painful mass in the right lower quadrant of the abdomen, is reported. Imaging showed a large, cystic structure at the base of the cecum. Surgery revealed a 8x5.5 cm calcified tumor, which was excided together with the appendiceal remnant. Pathological diagnosis was that of a mucocele arising from the appendiceal stump due to the development of a benign mucinous cystadenoma.
Mucocele
Mucinous cystadenoma
Cystadenoma
Pseudomyxoma Peritonei
Abdominal distension
Cystadenocarcinoma
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Appendicectomy is one of the most commonly performed surgical procedures. Appendiceal mucocele is a relative rare disease, but appropriate management is critical. Indeed, the intact removal of a mucocele represents a curative treatment; conversely, a rupture may result in the spread of epithelial cells throughout the peritoneal cavity (pseudomyxoma peritonei). We report a case of a 61-year-old woman, admitted to our department, who underwent resection of an appendiceal mucocele, focusing, in the discussion, on the clinical and surgical management of this disease.
Mucocele
Pseudomyxoma Peritonei
Peritoneal cavity
Rare disease
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International Journal of Case Reports and Images (IJCRI)International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.
Mucinous cystadenoma
Mucocele
Electronic journal
Cystadenoma
Pseudomyxoma Peritonei
Mucinous Tumor
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Background:Mucocele of the appendix is an uncommon cystic lesion characterized by distension of the appendiceal lumen with mucus. Most commonly, it is the result of epithelial proliferation, but it can also be caused by inflammation or obstruction of the appendix. When an underlying mucinous cystadenocarcinoma exists, spontaneous or iatrogenic rupture of the mucocele can lead to mucinous intraperitoneal ascites, a syndrome known as pseudomyxoma peritonei. Case Report:We report 2 cases that represent the clinical extremities of this heterogeneous disease; an asymptomatic mucocele of the appendix in a 70-year-old female and a case of pseudomyxoma peritonei in an 84-year-old male. Subsequently, we review the current literature focusing to the optimal management of both conditions. Conclusions:Mucocele of the appendix is a rare disease, usually diagnosed on histopathologic examination of appendectomized specimens. Due to the existing potential for malignant transformation and pseudomyxoma peritonei caused by rupture of the mucocele, extensive preoperative evaluation and thorough intraoperative gastrointestinal and peritoneal examination is required.
Pseudomyxoma Peritonei
Mucocele
Mucinous cystadenocarcinoma
Lumen (anatomy)
Cystadenocarcinoma
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This report documents 2 cases of obstructive mucocele of the appendix secondary to endometriosis of the appendix. In 1 case, the tip of the mucocele was ruptured and associated with localized pseudomyxoma peritonei. Mucoceles of the appendix usually are associated with hyperplastic or neoplastic mucosal proliferation; obstruction, particularly that due to endometriosis, is an infrequent cause. Occurrence of localized pseudomyxoma peritonei associated with appendiceal endometriosis and mucocele has not been reported previously.
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Pseudomyxoma Peritonei
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Acute appendicitis is one of the most common clinical presentations among the patients with acute abdominal pain.However, a through clinical and surgical evaluation is essential to manage atypical conditions such as carcinoids and the tumors of appendix or mucocele appendix.Here, we present a case with mucocele of appendix vermiformis due to mucinous cystadenoma with carcinoma in situ component.This case indicates that atypical presentations and clinical findings should be carefully managed in the patients with suspicious acute appendicitis in surgery.This is especially essential in the patients with appendiceal mass or mucocele in order to minimize complications.
Mucinous cystadenoma
Mucocele
Cystadenoma
Carcinoma in situ
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Mucocele of the appendix is a rare but well-recognized entity that can mimic several common clinical conditions or present as an incidental radiological or surgical finding at laparotomy. Mucoceles are characterized by distension of the lumen due to accumulation of mucoid substance. They can result from mucosal hyperplasia, mucinous cystadenoma, or mucinous cystadenocarcinoma. If untreated, they may rupture producing the potentially fatal entity Pseudomyxoma peritonei, which is difficult to treat both surgically or medically. Appendectomy is used for simple mucocele or for cystadenoma. Preoperative diagnosis of a mucocele is helpful at the time of surgical intervention with careful mobilization, particularly of large lesions reducing the possibility of rupture and complications. The authors report a case of a 65-year-old man presenting with peritonitis due to a pre-pyloric gastric perforation also having an incidental giant mucocele of the appendix.
Mucocele
Pseudomyxoma Peritonei
Mucinous cystadenoma
Cystadenoma
Perforation
Lumen (anatomy)
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