The 8% of the appendiceal tumors are presented with mucocele which is the dilatation of appendix by the pressure of secreted intralumi. Mural curvilinear interrupted calcification, suggestive of bowel origin is seen. Pdf the mucocele of the appendix is an uncommon disorder which is often asymptomatic but sometimes causes acute appendicitislike. Appendiceal mucocele diagnosed in patients with inflammatory. The entity was recognised by rokitansky in 1842 and was later named by feren in 1876. Mucus containing cystic lesions mucocele of the appendix. Laparoscopic appendectomy for acute appendicitis is frequently selected by patients and surgeons, and clinical studies show it to be a reasonable alternative. Pdf mucocele of appendix develops due to obstructive dilatation of the appendix leading to intraluminal accumulation of mucoid material. Hyperplastic polyp similar to colonic polyp mucinous neoplasm lamn and hamn most common mucinous cystadenocarcinoma simple mucocele below obstruction from endometriosis inspissated mucus cystic fibrosis. Colonoscopy revealed a submucosal cecal mass obliterating the appendiceal orifice and a 0. The mucocele of appendix or mucosecreting tumor is a rare affection defined as a cystic dilatation of the light of the appendix following the intra luminal accumulation of mucinous, translucent, gelatinous, secretion which may reach either the entire orga n or a segment more often distal. Twothirds of patients with highgrade cytology without invasion in the primary appendix developed recurrent adenocarcinoma in the peritoneum including all of the cases reported in the literature1,2, none of the cases had the entire appendix submitted.
Right hemicolectomy is recommended for cystadenocarcinoma 6. If a benign mucocele or cystadenocarcinoma involving the distal twothirds of the appendix is present, appendectomy may be per formed by operative laparoscopy. Lowgrade appendiceal mucinous neoplasm and endometriosis. Intestinal obstruction secondary to appendiceal mucocele. We report such a case presenting to the surgeons where initial clinical findings and investigations suggested an ovarian cyst.
Appendicular mucocele is a rare disease and constitutes 0. Though carcinoid tumor is the most common primary appendiceal neoplasm in surgical pathology series, mucoceles due to neoplasms are the most common appendiceal tumors detected on imaging 7. Appendiceal mucocele is an obstructive dilatation of the appendix caused by intraluminal accumulation of mucoid material. I just had a mucocele of the appendix removed 72211. The typical ct appearance of appendiceal mucocele is a cystic, round, or tubular wellencapsulated mass, sometimes with calcifications in the expected location of the appendix. Appendiceal mucocele am is a rare entity that can present with a variety of clinical symptoms or occur as an incidental surgical finding. Variability of appendiceal caliber in two patients with pathologyproved acute appendicitis. A wellcircumscribed tubular, elongated cystic lesion with a chicken drumstick appearance is seen in the right iliac fossa. They can be subdivided according to their histopathological morphology into four subgroups. Mucoceles from either benign or malignant mucinous neoplasm 1. Mar 21, 2020 admin march 21, 2020 march 21, 2020 no comments on appendiceal mucocele pdf mucocele of the appendix is a term used to describe a dilated, mucinfilled appendix. The patient was subsequently referred to the gynaecologists for further management.
Mucocele of the appendix and pseudomyxoma peritonei. The inferior part of the lesion is in contact with the normal right ovary. Preoperative assessment and treatment of appendiceal mucocele. Etiology mucoceles of the appendix are caused by excessive mucous production secondary to retention cyst simple 18%, mucosal hyperplasia 20%, mucinous cystadenoma 52% to 84%, or mucinous. Mucoceles of the appendix are rare cystic lesions characterized by a distended appendiceal lumen filled with mucus with an incidence of 0. Mucocele of the appendix is a cystic dilatation of the appendix caused by obstruction of the lumen either by nonneoplastic or neoplastic lesions. That is an uncommon condition with various and non specific clinical presentations which may. Appendiceal mucoceles occur when there is an abnormal accumulation of mucin causing abnormal distention of the vermiform appendix due to various. Appendiceal mucocele is a rare entity of mucinous cystic dilatation of the appendix. Diagnosis and treatment of mucinous appendiceal neoplasm. This article is from case reports in gastroenterology, volume 5. This approach necessitates using different names for the appendiceal primary and the metastatic peritoneal disease, which can result in considerable confusion in my opinion. They are thought to typically present in middleaged individuals, particularly considering the epidemiology of.
Mucocele in the enlarged appendix cancer survivors network. It is most commonly the result of epithelial proliferation, but can. Appendiceal mucoceles occur when there is an abnormal accumulation of mucin causing abnormal distention of the vermiform appendix due to various neoplastic or nonneoplastic causes. Appendiceal mucocele is a rare cause of acute abdomen. If treated improperly, the mucocele may progress, epithelial cells may escape into the. In this case study, laparoscopic surgery was used to resect an appendiceal mucocele caused by a nonperforated mucinous adenocarcinoma. Following informed consent, surgical exploration revealed a cystic mass.
I check in every once in awhile and i pray for all of you. Appendiceal mucocele surgical pathology criteria stanford. A quarter of patients are asymptomatic and the tumor is discovered incidentally. Appendiceal mucocele is a rare entity that corresponds to a descriptive macroscopic term, referring to a focal or diffusely dilated appendix with accumulation of mucus in its lumen 48. Intussusception is a rare complication of appendiceal mucocele incidence about 0,01 % 11, that can manifest as colic pain in right lower quadrant, obstruction and gastrointestinal bleeding. The simple mucocele or appendiceal retention cyst is caused by an obstruction of the appendix base that can be caused by many etiologies. The epithelial lining of the appendix consists of abundant exocrine goblet cells, and thus most tumour types seen in appendiceal samples are mucus producing. Preoperative diagnosis of appendix mucocele changing the course of management has been reported. Mucocele of the appendix is associated with morbid complications. However, the ability to differentiate malignant and benign mucoceles with ct has been rarely reported in the literature. Abdominal ct scan suggested a diagnosis of a appendicular mucocele. A contrastenhanced ct scan showed a cystic mass with peripheral enhancement in the region of the cecum and a small amount of free fluid in the pelvis. It is characterized by a located or diffuse distension of the appendix with a mucusfilled lumen. The entire appendix should be examined microscopically.
The frequency of primary appendiceal tumours is reported to be 0. Mucocele of the appendix is a descriptive term for an appendix distended by mucus, secondary to mucinous cystadenoma 63%, mucosal hyperplasia 25%, mucinous cystadenocarcinoma 11%, and retention cyst. My husband just celebrated 4 years cancer free stage 3 rectal cancer it was a rough couple of years, but life has been good since. Am is a progressive dilatation of the appendix from the intraluminal accumulation of the mucoid substance3,4. Mucocele of the appendix is an infrequent event, representing 0. Appendiceal mucocele am is a descriptive term for dilated appendiceal lumen, caused by abnormal accumulation of mucus. Appendiceal mucocele is a rare group of lesions characterized by mucinous distension of the appendiceal lumen with the dangerous potential to rupture, resulting in the development of pseudomyxoma peritonei. Appendiceal intussusception to the cecum caused by mucocele of the appendix is a rare cause of abdominal pain and difficult to diagnose. While older literature on appendiceal mucoceles often failed to distinguish between benign and neoplastic lesions, the classification of appendiceal epithelial tumors of the appendix peritoneal mucin that is associated with a ruptured lamn or, less commonly, a ruptured benign appendiceal mucocele. Apr 24, 2014 indications and contraindications to laparoscopic surgery continue to be refined. Mucocele of the appendix secondary to mucinous cystadenoma is a rare clinical finding. A mucocele of the appendix is a rare entity contributing to 0.
Laparoscopic appendectomy for mucocele of the appendix. Mucocele of the appendix is a term used to describe a dilated, mucinfilled appendix. We distinguish four subtypes characterized with nonspecific clinical manifestations. Pelviscopic removal of an appendiceal mucocele sciencedirect. Preoperative assessment and treatment of appendiceal. Few cases of intestinal obstruction complicating an appendiceal mucocele have been recorded. Pseudomyxoma peritonei is characterized by mucinous ascites and implants throughout the abdominal cavity. Appendiceal mucocele am is a descriptive term for dilated appendiceal lumen, occasionally observed in either symptomatic. An update on the diagnosis, grading, and staging of. Hypothesis clinical presentation of appendiceal mucocele is related to malignancy and can influence surgical approach. Appendectomy is used for simple mucocele or for cystadenoma. Sushila hamad medical corporation clinical imaging, hgh p.
To download the pdf, click the download link below. A distended, mucousfilled appendix is known as an appendiceal mucocele. Grossly dilated appendix filled with mucus clinical but not a histologic diagnosis causes. Pdf laparoscopic resection of a appendiceal mucocele. Ruptured mucocele of appendix volume 2 issue 4 2015 sushila ladumor, adham darwish, ala kamble and maysa abdul hafeez hamad medical corporation clinical imaging, qatar corresponding author. Mucoceles are more common in males than in females and.
Excessive production of mucus by adenomatous tumours leads to the formation of a mucocele. It has also been described in cases of endometriotic implants and melanoma metastasis. Appendiceal mucocele appendiceal mucoceles occur when there is an abnormal accumulation of mucin causing abnormal distention of the vermiform appendix due to various n. Mucocele of the appendix is a descriptive term of a distended, mucusfilled appendix caused by various conditions, both benign and malignant. Apr 14, 2008 appendiceal mucocele am is a rare entity that can present with a variety of clinical symptoms or occur as an incidental surgical finding. The laparoscopic surgery for appendiceal tumors is. It has no typical clinical presentation and is considered a potentially premalignant condition. Molecular analysis of appendiceal mucinous cystadenoma and. Any information contained in this pdf file is automatically generated from digital material. Endoscopically, am looks like submucosal tumor of the cecum, and may mimic lipoma, gastrointestinal stromal tumor, or neuroendocrine tumor. Its natural to be a little worried when a new lump or bump forms on your body. Patients all cases of primary appendiceal mucoceles simple mucocele, cystadenoma.
They are a rare form of an appendiceal mass and develop from both benign and malignant processes. Ct diagnosis of mucocele of the appendix in patients with. Ladumor s, darwish a, kamble a, hafeez ma 2015 ruptured mucocele of appendix. Etiological factors range from inflammatory to neoplastic, and. Clinical presentation may include right lower quadrant pain, change in bowel habits, per rectal bleeding, or a palpable mass. The patients manifest a variety of symptoms, but can also be asymptomatic. We report the case of a young woman who presented to the emergency room with diffusely abdominal pain, nausea, vomiting and disruption of bowel movements. Mucocele is a descriptive term referring to a dilated appendix with abnormal intraluminal accumulation of mucus 1, 2. Abstractappendiceal mucoceles are rare cystic lesions with an incidence of 0.
Mucocele of the appendix appendectomy or colectomy. This lesion is lying vertically and is continuous with the terminal end of the appendix. It can be triggered by benign or malignant diseases, which cause the obstruction of the appendix and the consequent accumulation of mucus secretion. Only 12 cases of nonneoplastic appendiceal mucoceles caused by. The mucocele of the appendix was first described in 1842 by rokitansky1. The pdf file you selected should load here if your web browser has a pdf reader plugin installed for example, a recent version of adobe acrobat reader. Pdf mucocele of the appendix and pseudomyxoma peritonei. To illustrate the radiologic findings of appendiceal pathologies as shown with conventional radiology, us, ct and mr. Its a complication can be seen in up to 6 % of appendiceal mucoceles 7, 11. If other malignant tumors or pseudomyxoma peritonei is present, laparo tomy should be carried out. As far as i know, this approach to nomenclature is.
The presence of wall calcification strongly supports a diagnosis of appendiceal mucocele, but this characteristic is seen in less than 50% of cases 5, 6. Mucocele of the appendix is a rare condition, the pathological classification and management strategy of which have not been standardized yet. We describe 35 cases of mucocele of the appendix diagnosed at ramon y cajal hospital between january 1985 and january 2006. The appendiceal mucocele isnt a disease in itself, its a form of presentation several entities. Appendiceal mucocele video journal and encyclopedia of. Mucoceles can develop secondarily to an obstruction, such as from a fecalith, scarring or, rarely, endometriosis. Appendiceal mucocele am is a descriptive term for dilated appendiceal lumen, occasionally observed in either symptomatic or asymptomatic patients during colonoscopy. The presence of punctate or curvilinear calcification in this wall confirms the mucocele diagnosis and differs from the appendicular abscess, which does not have this characteristic6. The patient was subsequently referred to the gynaecologists for further. We had 9 cases, three males and sex females, with a median age of 62 years. To report on our management of appendiceal mucocele, highlighting the pitfalls and possible means for avoiding them. Alternatively, you can also download the pdf file directly to your computer, from where it can be opened using a pdf reader. Teri a longacre md robert v rouse md department of pathology.
The aim of this study is to report a case of a mucinous appendiceal neoplasm presented as acute appendicitis, discussing the clinical and surgical approach in the emergency setting. Pubmed, searched by using the term appendiceal mucocele and mucocele. After re section, the diagnosis of a mucinous cystadenoma of the appendix was confirmed on pathological examina tion fig. The term mucocele is simply a macroscopic description of an appendix that is grossly distended by mucus 7,12. The type of surgical treatment is related to the dimensions and to histology of the mucocele. In both the endoscopy and the barium enema, the appendiceal mucocele can be detected as an elevation or a soft print located on the medial side of the cecal pole that suggests the presence of an extramucosal or extrinsic process fig. Dec 18, 2014 mucocele of the appendix is a cystic dilatation of the appendix caused by obstruction of the lumen either by nonneoplastic or neoplastic lesions. The first description of mucoceles of the appendix was made by rokitansky in 1842, who described a dilatation of the appendiceal lumen due to mucus accumulation. When a bulging appendiceal orifice is observed during surveillance colonoscopy, the possibility of appendiceal mucocele must be considered. A mucocele can be an incidental finding at surgery or imaging.
Indications and contraindications to laparoscopic surgery continue to be refined. May 25, 2007 appendiceal mucocele is a rare but wellrecognized entity that can mimic several common clinical syndromes or present as an incidental surgical or radiological finding. If untreated, one type of mucocele may rupture producing a potentially fatal entity known as pseudomyxoma peritonei. Surgical treatment of appendiceal mucocele colorectal. The mucocele of appendix or mucosecreting tumor is a rare affection defined as a cystic dilatation of the light of the appendix following the intra luminal accumulation of mucinous, translucent, gelatinous, secretion which may reach either the entire orga n or a. Pseudomyxoma peritonei means false peritoneal tumor.
In this case study, laparoscopic surgery was used to resect an appendiceal mucocele caused by a nonperforated. Pdf mucocele of the appendix is a descriptive term for an abnormal mucous accumulation distending the appendiceal lumen. Appendiceal mucocele can be caused by chronic obstruction of the appendix simple mucocele or result from mucosal hyperplasia and benign or malignant neoplasms of the appendix 3, 4. Appendiceal mucocele, first described by rokitansky, is a morphologic entity referring to localized or diffuse dilatation of the appendiceal lumen by abnormal accumulation of mucus. Mucoceles are rare tumors accounting for 8% to 10% of appendiceal tumors and cause 0. It is most commonly the result of epithelial proliferation, but can be caused. Appendix mucocele may come as a consequence of obstructive or inflammatory processes, cystadenomas or. Ct can reveal appendicular pathology and suggest the presence of an appendicular mucocoele. Nov 16, 2019 appendiceal mucocele pdf mucocele of the appendix is a term used to describe a dilated, mucinfilled appendix. If you or your child develops a soft swelling in the mouth, it may just be a mucocele. Appendiceal mucoceles comprise a group of lesions characterized by a distended, mucusfilled appendix. Clinical presentation is varied with more than half being asymptomatic.