scholarly journals Mucus Containing Cystic Lesions “Mucocele” of the Appendix: The Unresolved Issues

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Mohammad Ezzedien Rabie ◽  
Mubarak Al Shraim ◽  
Mohammad Saad Al Skaini ◽  
Saad Alqahtani ◽  
Ismail El Hakeem ◽  
...  
Keyword(s):  
Pseudomyxoma Peritonei ◽  
Mucinous Cystadenoma ◽  
Right Hemicolectomy ◽  
Malignant Potential ◽  
Low Grade ◽  
Uncertain Malignant Potential ◽  
Appendiceal Mucocele ◽  
Mucocele Of The Appendix ◽  
Mucinous Tumours ◽  
Mucinous Tumour

Background. Mucocele of the appendix is a rare condition, the pathological classification and management strategy of which have not been standardized yet.Aim. To report on our management of appendiceal mucocele, highlighting the pitfalls and possible means for avoiding them.Materials and Methods. Our registries were reviewed to retrieve cases of appendiceal mucocele, encountered in the period from July 2008 to May 2013.Results. We had 9 cases, three males and sex females, with a median age of 62 years. Abdominal ultrasound (US) and computerized axial tomography scan (CT) suspected the diagnosis in only one case each. Open appendectomy was done in two cases of mucinous cystadenoma with no further surgery performed, despite the positive margin in one. Laparoscopic appendectomy was done in three cases: mucinous cystadenoma in one case which needed no further surgery, mucinous cystadenocarcinoma with pseudomyxoma peritonei in another, and low grade mucinous tumour in a third case, and all needed subsequent right hemicolectomy. Exploratory laparotomy was done in three cases: of these, synchronous right hemicolectomy was done in one case of mucinous cystadenoma/?mucinous tumour of uncertain malignant potential; in the other two cases, appendectomy only was done for mucinous hyperplasia with carcinoid tumour of the appendix in one case and mucinous cystadenoma/?mucinous tumour of uncertain malignant potential in another. The 9th case was discovered upon laparoscopy for cholecystectomy; when pseudomyxoma peritonei arising from an appendiceal mucocele was found, laparoscopic appendectomy with peritoneal biopsy was then performed instead. Histopathologic diagnostic uncertainty was present in two cases of mucinous cystadenoma where mucinous tumour of uncertain malignant potential was an alternative possibility. Perioperative colonoscopy was performed in only one case and our follow-up programme was defective, with the longest period being 180 days.Conclusion. Mucocele of the appendix should be considered in the differential diagnosis of cystic lesions in the right lower abdomen. Owing to its rarity, it continues to intrigue the surgeon as well as the radiologist and pathologist alike. For mucinous cystadenocarcinoma, right hemicolectomy is usually needed, whereas for hyperplasia and cystadenoma, appendectomy usually suffices if the resection margins are free. For mucinous tumours of uncertain malignant potential and low grade mucinous tumours as well as pseudomyxoma peritonei, the decision is not as simple. As for laparoscopic surgery, no solid proof exists with or against its safety. Although not yet standardized, perioperative colonoscopy and regular follow-up to detect early recurrences should probably be part of the management plan.

EP.FRI.999 Case report of a Low Grade appendiceal mucinous neoplasm (LAMN) and review of literature

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Kimberly Da Costa ◽  
Sivakumaran Sabanathan
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Pseudomyxoma Peritonei ◽  
Right Hemicolectomy ◽  
Low Grade ◽  
Mucinous Neoplasm ◽  
Mucinous Neoplasms ◽  
Mucocele Of The Appendix ◽  
Preoperative Ct ◽  
Inflammatory Processes ◽  
Progressive Accumulation

Abstract A mucocele refers to an appendix that has dilated due to progressive accumulation of mucus within its lumen. Appendiceal mucocele is a rare cause of an acute abdomen. They represent 0.2-0.7% of all appendix specimens. LAMN account for less than 0.3% of appendicectomy specimens.  We present a 38 year old man with an acute RIF’s pain who went on to have CT scan which revealed a mucocele of appendix but did not show any features of perforation or pseudomyxoma peritonei. He had a laparoscopic converted to open appendicectomy. The proximal 2 cm of appendix was oedematous but normal calibre. Histology revealed a low grade appendiceal mucinous neoplasm (LAMN) that was completely excised.  The mucocele of the appendix was first described by Rokitansky in 1842. Appendix mucocele may come as a consequence of obstructive or inflammatory processes, cystadenomas or cystadenocarcinomas. Appendiceal mucinous neoplasms commonly presents in the sixth decade of life and our patient was much younger in comparison. Several literatures suggest the value of preoperative CT imaging in obtaining diagnosis and also in planning further treatment. Appendicectomy or a right hemicolectomy is treatment of choice based on presence or absence of following factors 1. Perforated mucocele 2. Involvement of the base of the appendix. 3. Positive lymph nodes of mesoappendix and ileocolic. Patients with malignancy or pseudomyxoma peritonei are likely to require cytoreductive surgery, heated intraoperative intraperitoneal chemotherapy, early postoperative intraperitoneal chemotherapy.

scholarly journals Low-Grade Malignancy Glomus Tumor in a Setting of Multiple Glomus Tumors – Case Report

2019 ◽  
Vol 7 (23) ◽  
pp. 4082-4088
Author(s):  
Violeta Vasilevska-Nikodinovska ◽  
Milan Samardjiski ◽  
Rubens Jovanovik ◽  
Boro Ilievski ◽  
Vesna Janevska
Keyword(s):  
Glomus Tumor ◽  
Subcutaneous Tissue ◽  
Vena Cava ◽  
Malignant Potential ◽  
Biological Behavior ◽  
Low Grade ◽  
Uncertain Malignant Potential ◽  
Glomus Tumors ◽  
Small Nodule ◽  
Multiple Lesions

BACKGROUND: Glomus tumors are rare neoplasms accounting for less than 2% of all soft tissue tumors but multiple lesions may be seen in up to 10% of the patients. Solitary glomus tumor (GT) most frequently appears as small nodule in specific locations such as subungual region or deep dermis. However, rarely these entities have been observed in extracutaneous locations such as the gastrointestinal, cardiovascular, respiratory tracts, and other visceral organs. A small fraction of the GTs may present as tumors of uncertain malignant potential or as malignant glomus tumors. CASE PRESENTATION: We report a patient with multiple glomus tumors on the time of diagnosis, which was histologically diagnosed as an atypical glomus tumor following resection of a tumor thrombus in the left renal vein, inferior vena cava trombus with intracardial extension, and mitral valve specimen. The intramuscular lesion from the thigh was diagnosed as a glomus tumor of uncertain malignant potential. Further examinations revealed multiple lesions trough her body: kidneys, breast, heart and subcutaneous tissue. The diagnosis of glomus tumor of uncertain malignant potential versus glomus tumor with low malignant potential could be quite challenging, and the clinical course may be as a determining factor for final diagnosis. CONCLUSION: To our knowledge, this is the only known case of glomus tumor with multiple organ involvement and aggressive biological behavior at presentation.

scholarly journals Mucocele of the appendix in a 77-year-old man with calcinosis, Raynaud’s phenomenon, esophageal dysfunction, sclerodactyly and telangiectasias syndrome

2016 ◽  
Vol 7 (1) ◽  
Author(s):  
Hanen Loukil ◽  
Faten Frikha ◽  
Mouna Snoussi ◽  
Zouhir Bahloul
Keyword(s):  
Raynaud’S Phenomenon ◽  
Mucinous Cystadenoma ◽  
Vermiform Appendix ◽  
Raynaud's Phenomenon ◽  
Unusual Complication ◽  
Computed Tomography Scan ◽  
Appendiceal Mucocele ◽  
Mucocele Of The Appendix ◽  
Esophageal Dysfunction ◽  
Tomography Scan

Mucocele is an uncommon pathology of the vermiform appendix estimated to be seen in 0.2-0.3%. The term mucocele means dilation of the appendix due to mucus, caused either by a benign or a malignant process. Herein, we report the case of a 77-year-old man with Calcinosis, Raynaud’s phenomenon, Esophageal dysfunction, Sclerodactyly and Telangiectasias syndrome, a limited form of Scleroderma, who had presented an abdominal cyclical pain and in which abdominopelvic computed tomography scan concluded to the diagnosis of appendiceal mucocele. Surgery and histopathology confirmed the diagnosis of mucinous cystadenoma. This association appendiceal mucocele and scleoderma has not been previously reported. The clinical and radiological features of this unusual complication are reviewed.

Clinical outcome of atypical uterine smooth muscle tumors

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15028-15028 ◽  
Author(s):  
B. Pothuri ◽  
S. M. Kehoe ◽  
T. Wright ◽  
T. Herzog
Keyword(s):  
Smooth Muscle ◽  
Clinical Outcome ◽  
Retrospective Chart Review ◽  
Malignant Potential ◽  
Low Grade ◽  
Uncertain Malignant Potential ◽  
Histologic Diagnosis ◽  
Cellular Atypia ◽  
Smooth Muscle Tumors

15028 Background: Smooth muscle tumors of uncertain malignant potential (STUMP) and atypical leiomyomas have increased mitotic activity, cellular atypia and necrosis but the degree is less than that used to define uterine leiomyosarcomas. Our objective is to evaluate the clinical outcome of patients with uterine masses histologically defined as smooth muscle tumors of uncertain malignant potential or atypical leiomyomas. Methods: A thorough search of our institution’s pathology database from 1990 to 2005 was performed. A retrospective chart review was performed to obtain initial and subsequent treatments, documented recurrences and clinical outcomes. Pathology reports and slides were reviewed and the presence of atypia, necrosis and number of mitosis was recorded. Statistical analysis was performed by Student’s T-test. Results: Eighteen patients with a histologic diagnosis of atypical leiomyoma were identified with 14 STUMP, 2 bizarre leiomyomas, 1 myxoid and 1 mitotically active leiomyoma. The mean age of these patients was 41.8 years (range: 25–77) and was significantly younger than those with leiomyosarcoma (mean age was 54 years, p < 0.001). The histologic characteristics of the tumors included the presence of atypia at 50%, necrosis at 82% and mitoses at 94%. The rate of necrosis and number of mitosis was significantly less in the atypical group as compared to the leiomyosarcoma group (p values < 0.05). However the rate of cellular atypia was not statistically different between the two groups. The median follow-up period was 25 months, range 1–138 months. One of the eighteen patients developed a pelvic and pulmonary recurrence at which time a low grade leiomyosarcoma was diagnosed. The recurrence occurred 32 months after the initial diagnosis of a mitotically active leiomyoma. Sixteen patients demonstrated no recurrence or metastatic disease at the time of follow-up. Conclusions: Atypical leiomyomas appear to be diagnosed in younger women which leads to challenging treatment issues involving fertility preservation. While these tumors generally behave in a benign fashion, they have histologic characteristics that may allow for progression or recurrence. Close follow-up is warranted for patients who are diagnosed with atypical leiomyomas and smooth muscle tumors of uncertain malignant potential. No significant financial relationships to disclose.

Incidental appendiceal neoplasias: ten years' experience with 1,642 patients

2020 ◽  
Keyword(s):  
Demographic Data ◽  
Tertiary Care ◽  
Mucinous Cystadenoma ◽  
Right Hemicolectomy ◽  
Low Grade ◽  
Pathological Findings ◽  
Sessile Serrated Adenoma ◽  
Serrated Adenoma ◽  
Positive Surgical Margins ◽  
Large Tertiary Care

Background: Acute appendicitis is the most common surgical emergency. In this study, we investigated the rate of neoplasia among patients who underwent an appendectomy in our center, a large Tertiary Care Teaching Hospital. Methods: We retrospectively reviewed 1,642 cases of appendectomies performed between 2007 and 2017. In this study, the data included demographic data, operative and pathological findings, and additional procedures following the appendectomy. Results: Of the 1,642 appendectomies, 1,294 were laparoscopic, and 348 were open procedures. Appendiceal neoplasia was encountered in the examination of appendix specimens taken from 20 patients. Sessile serrated adenoma (SSRA) was found in seven patients, neuroendocrine tumor (NET) in six patients, low-grade mucinous neoplasia (LGMN) in four patients, mucinous cystadenoma (MCA) in two patients, and diffuse adenoma (DA) in one patient. Two patients underwent right hemicolectomy due to positive surgical margins from previous surgeries. Colonoscopy and computed tomography (CT) control were performed on all neoplasia patients during the postoperative period, and no additional pathology was seen. Conclusions: Although the probability of neoplasia after appendectomy is low, it should be considered. Adenomas and neuroendocrine tumors seem to be the most common neoplasias that are incidentally encountered in appendectomy specimens.

scholarly journals Case Report: Intussepting mucocele appendix

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1939
Author(s):  
Tom Crawley-Smith
Keyword(s):  
Case Report ◽  
Iliac Fossa ◽  
Rare Condition ◽  
Operative Management ◽  
Right Hemicolectomy ◽  
Malignant Potential ◽  
Rare Presentation ◽  
Mucocele Of The Appendix ◽  
Right Iliac Fossa Pain

Background: A case study of a presentation of a mucocele appendix, a rare condition accounting for 0.2% of appendicectomies. The case and operative management are discussed along with the possible progression to pseudomyxoma peritoneii and its differing management. Case: A 15-year-old girl had two presentations with atypical Right Iliac Fossa pain over 2 months. This was investigated with ultrasound and CT which revealed a calcified, intussusepting mucocele of the appendix. This was surgically resected with partial Right Hemicolectomy. The patient was discharged on day 3 with no complications. Discussion: The presentation, malignant potential, investigation and management of the mucocele appendix are discussed. The rare presentation of a mucocele appendix necessitates care to eliminate the risk of pseudomyxoma peritoneii. The operative management should minimise disturbance of the peritoneum in this presentation. In this case, due to an intersussepting nature a limited Right Hemicolectomy had to be performed. This is compared to the literature.

Treatment of pseudomyxoma peritonei by intraoperative and intraperitoneal chemotherapy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16540-e16540
Author(s):  
M. Friedrich ◽  
W. Poleska ◽  
J. Baltzer ◽  
D. Salehin
Keyword(s):  
Side Effects ◽  
Intraperitoneal Chemotherapy ◽  
Pseudomyxoma Peritonei ◽  
Mucinous Cystadenoma ◽  
Ovarian Tumour ◽  
The Other ◽  
Mucinous Cystadenocarcinoma ◽  
Borderline Tumour ◽  
Mucinous Tumours

e16540 Background: Pseudomyxoma peritonei occurs mostly in conjunction with the type of intestinal mucinous borderline tumour and is characterized by building up a lot of mucus pour of cells. The most common tumor is the pseudomyxoma peritoneii with mucinous borderline tumours of the ovaries or with mucinous tumours of the appendix, normally without showing a rupture of the ovarian tumour pre- or intraoperatively. The diagnosis of pseudomyxoma peritonei is mainly difficult and guidelines for the treatment are unknown. Methods: In the period from 1991 to 2008, 52 patients with pseudomyxoma peritonei were treated by tumour debulking and intraoperative and intraperitoneal chemotherapy with Mitoxantron (40 mg in 300 ml of NaCl over 72 hours). During the tumour debulking a CUSA system was used. Results: The median follow-up was 8.2 years. There were the following histologies: mucinous cystadenoma of the ovary n = 29, mucinous cystadenoma of the appendix n = 10, mucinous cystadenocarcinoma n = 13. Reccurrences were seen in 4 patients. These patients were treated for reccurrences by the same way as mention above. All these patients were now without any recurrences. The other 48 patients are still alive with recurrences. Conclusions: The instillation of mitoxantron intraperitoneally and intraoperatively is an effective and safe therapy without any side effects after maximal tumour debulking of pseudomyxoma peritoneii. No significant financial relationships to disclose.

scholarly journals Hormone dependency in metastatic low-grade leiomyosarcoma following uterine smooth muscle tumour of uncertain malignant potential

2014 ◽  
Vol 2014 (mar27 1) ◽  
pp. bcr2013202107-bcr2013202107 ◽  
Author(s):  
C. Serrano ◽  
M. R. Nucci ◽  
S. H. Tirumani ◽  
C. P. Raut ◽  
S. George
Keyword(s):  
Smooth Muscle ◽  
Malignant Potential ◽  
Low Grade ◽  
Uncertain Malignant Potential ◽  
Smooth Muscle Tumour ◽  
Uterine Smooth Muscle ◽  
Hormone Dependency
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