Corresponding author. Corresponding author: Thomas H. Abstract Mucocele of the appendix is a term used to describe a dilated, mucin-filled appendix. It is most commonly the result of epithelial proliferation, but can be caused by inflammation or obstruction of the appendix. Two cases of mucocele of the appendix are presented with a discussion of the histologic and radiologic features as well as the surgical management.
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There were patients, 74 of whom were female. Mean age at diagnosis was 59 years. Mean follow-up was more than 6 years. The lesion size was not associated with malignancy; however, cystadenomas were significantly larger than simple mucoceles 8. All mucoceles greater than 2 cm should be excised to remove premalignant lesions.
The purpose of our study was to identify the clinical, diagnostic, and surgical factors that might be associated with malignancy and affect the surgical management of appendiceal mucocele. Methods Institutional review board approval was obtained for this retrospective study.
All patients with a diagnosis of primary appendiceal mucocele treated in our institution between January 1, , and December 31, , were included. Patients presenting with recurrent malignant mucoceles after primary surgical treatment elsewhere were excluded.
We subdivided the mucoceles histologically on the basis of the World Health Organization classification. Cystadenoma was defined as the dilated, mucus-filled appendix containing adenomatous mucosa, and cystadenocarcinoma as the presence of adenocarcinoma associated with a dilated, mucus-filled appendix. However, the definition of mucinous tumor of uncertain malignant potential was not used in the pathology reports and, therefore, could not be considered as a separate category.
Collected demographic data included age, sex, and overall survival at the time of the last follow-up visit or letter. Specific symptoms collected included abdominal pain, abdominal mass, weight loss, nausea or vomiting, obstipation, and change in bowel habits.
A clinical syndrome suggestive of acute appendicitis was considered separately in the data collection. Pathological data included histologic findings, based on the classification mentioned herein; size of the lesions, considered as the longest diameter at the time of histologic examination; and presence and location of synchronous tumor.
Use of diagnostic tests barium enema, colonoscopy, computed tomographic [CT] scan, and ultrasound for each patient was recorded, as were data on accuracy in preoperative diagnosis.
In particular, the finding from each diagnostic modality was considered in relation to the final histologic diagnosis as being true positive, false negative, or indeterminate.
Cases of false-positive or true-negative findings in the diagnostic assessment of appendiceal mucocele were not considered. Patient comorbid conditions were recorded and classified as "severe" on the basis of clinical and diagnostic assessment.
Surgical data included indication for surgery; extent and type of procedures performed; presence of localized mucus collections around the appendix, whether the appendix was intact or spontaneously ruptured; and presence of mucus diffusely in the peritoneum pseudomyxoma peritonei.
The primary outcomes of interest were presence of malignant mucocele and perioperative morbidity. Clinical and demographic variables were evaluated to determine the strength of their associations with the outcomes of interest. Multivariate logistic regression
Low-grade appendiceal mucinous neoplasm and endometriosis of the appendix
The authors discuss the diagnostic workup of an appendiceal mucocele from computed tomography scanning to resection, emphasizing the influence of pathological diagnosis on the operative procedure. Right hemicolectomy is sufficient for most patients with appendiceal mucocele; however, the significant risk of postoperative complications and concomitant life-threatening conditions has led the authors to recommend careful resection and exploration of the peritoneum. Appendiceal mucocele is a rare but well-recognized entity that can mimic several common clinical syndromes or present as an incidental surgical or radiological finding. It has a 0. Depending on the location of the appendix, other signs may be observed, such as hematuria. The most dreaded complication of benign or malignant mucocele is pseudomyxoma peritonei, which is difficult to treat surgically or medically.
Surgical Treatment of Appendiceal Mucocele
Abstract Background A distended, mucous-filled appendix is known as an appendiceal mucocele. They are a rare form of an appendiceal mass and develop from both benign and malignant processes. Mucoceles can develop secondarily to an obstruction, such as from a fecalith, scarring or, rarely, endometriosis. Only 12 cases of non-neoplastic appendiceal mucoceles caused by endometriosis have been previously described.
Mucocele of the appendix
Abstract Introduction Appendicular mucocele is a rare well-described clinico-pathological occurrence. It denotes an obstructive dilatation of the appendicular lumen by mucinous secretions. Case report A year-old patient presented with right lower abdominal pain and nausea for 2 years. Abdominal CT scan suggested a diagnosis of a appendicular mucocele. Following informed consent, surgical exploration revealed a cystic mass arising from the body of the appendix with inflamed walls with no evidence of perforation. Simple appendectomy was performed as the caecum and the mesenteric nodes were free of pathological involvement. The final diagnosis of mucinous cystadenoma was confirmed by histopathology.