scholarly journals Low-Grade Appendiceal Mucinous Neoplasm Involving the Endometrium and Presenting with Mucinous Vaginal Discharge

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Vera Vavinskaya ◽  
Joel M. Baumgartner ◽  
Albert Ko ◽  
Cheryl C. Saenz ◽  
Mark A. Valasek
Keyword(s):  
Pseudomyxoma Peritonei ◽  
Vaginal Discharge ◽  
Low Grade ◽  
Invasive Adenocarcinoma ◽  
Peritoneal Disease ◽  
Mucinous Neoplasm ◽  
Mucinous Neoplasms ◽  
Pathological Evaluation ◽  
Classification Management

Primary appendiceal mucinous lesions are uncommon and represent a spectrum from nonneoplastic mucous retention cysts to invasive adenocarcinoma. Low-grade appendiceal mucinous neoplasms (LAMNs) represent an intermediate category on this spectrum and can be classified according to whether or not they are confined to the appendix. Although LAMNs are frequently confined to the appendix, they can also spread to the peritoneum and clinically progress as pseudomyxoma peritonei (i.e., mucinous ascites). Thus, the appropriate classification of appendiceal primary neoplasia is essential for prognosis and influences clinical management. In addition, the precise classification, management, and clinical outcome of patients with disseminated peritoneal disease remain controversial. Here, we report an unusual case of LAMN with pseudomyxoma peritonei that initially presented with mucinous and bloody vaginal discharge. Pathological evaluation revealed low-grade appendiceal mucinous neoplasm with secondary involvement of the peritoneum, ovaries, and endometrial surface. Therefore, LAMN should be considered in the differential diagnosis of mucinous vaginal discharge.

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 Classification of mucinous appendiceal neoplasm and pseudomyoxma peritonei

2018 ◽  
Vol 8 (1) ◽  
pp. 1301-1307
Author(s):  
Arnab Ghosh
Keyword(s):  
Goblet Cell ◽  
Wide Spectrum ◽  
Low Grade ◽  
Controversial Issues ◽  
High Grade ◽  
Goblet Cell Carcinoid ◽  
Signet Ring Cells ◽  
Mucinous Neoplasm ◽  
Signet Ring

Mucinous appendiceal tumors are uncommon and include a wide spectrum of tumors whose classification remained controversial. Some of these mucin producing appendiceal tumors can disseminate to the peritoneal cavity leading to pseudomyxoma peritonei (PMP). Despite several attempts to classify mucinous tumors of appendix and PMP by different authors in the past, no universally accepted classification system was present. The controversial issues were discussed at the 2012 World Congress of the Peritoneal Surface Oncology Group International (PSOGI) in Berlin. A panel of 71 experts from 13 different countries was formed under the lead co-ordinator Norman J. Carr. A total of 4 rounds of questionnaires and one meeting were held. The opinion of the majority was taken into account. Importance of intactness of muscularis mucosae, pushing invasion and infiltrative invasion were emphasized. The entities Low grade appendiceal mucinous neoplasm (LAMN) and High grade appendiceal mucinous neoplasm (HAMN) were defined.. The terminologies suggested for Goblet cell carcinoid and adenoneuroendocrine carcinoma were goblet cell tumor and adenocarcinoma ex goblet cell carcinoid. Acellular mucin in peritoneum was not classified under PMP which was classified into 3 categories depending upon low grade , high grade cytologic features and presence of signet ring cells. It was suggested to report the extent of mucin and cells separately. A reporting format solely for mucinous appendiceal tumors was formulated by the panel. However, there are some grey areas which may have to be addressed in future.

Diagnostic concordance in cases of appendiceal mucinous neoplasia referred to a tertiary referral centre

2019 ◽  
Vol 72 (9) ◽  
pp. 639-641 ◽  
Author(s):  
Aliasger Amin ◽  
Norman Carr
Keyword(s):  
Accurate Diagnosis ◽  
Low Grade ◽  
Referral Centre ◽  
Tertiary Referral ◽  
Tertiary Referral Centre ◽  
Peritoneal Disease ◽  
Mucinous Neoplasm ◽  
Mucosal Changes ◽  
Diagnostic Concordance ◽  
Peritoneal Malignancy

Accurate diagnosis of appendiceal tumours and any associated peritoneal disease is clinically important but can be difficult. We retrieved the records of patients referred to the Peritoneal Malignancy Institute, Basingstoke, in the years 2016, 2017 and 2018 with a diagnosis of mucinous appendiceal neoplasia and identified 323 patients in which slides were reviewed as part of the referral pathway. Comparing the local report from the referring centre with the central review report, in 57 (18%) we identified a discrepancy. In 39 (12%) the discrepancy was in overall diagnosis, including 22 (7%) in which the local diagnosis was low-grade appendiceal mucinous neoplasm whereas the review diagnosis was reactive mucosal changes, usually due to ruptured diverticulum, with no evidence of neoplasia. Our findings support the practice of central review of histopathology slides by experienced pathologists at tertiary referral centres. They also suggest that improvements in diagnostic criteria are needed.

A Patient With a Low-grade Mucinous Neoplasm Involving the Ovary and Pseudomyxoma Peritonei Originating in an Isolated Intestinal Duplication

2018 ◽  
Vol 37 (4) ◽  
pp. 338-343
Author(s):  
Michiel Simons ◽  
Inge Ebisch ◽  
Joanne de Hullu ◽  
Maaike van Ham ◽  
Marc Snijders ◽  
...  
Keyword(s):  
Pseudomyxoma Peritonei ◽  
Low Grade ◽  
Intestinal Duplication ◽  
Mucinous Neoplasm

Clinicopathological Characteristics of Low-Grade Appendiceal Mucinous Neoplasm

2021 ◽  
pp. 1-8
Author(s):  
Tatsuro Yamaguchi ◽  
Kohei Murata ◽  
Tetsuya Shiota ◽  
Hiroshi Takeyama ◽  
Shingo Noura ◽  
...  
Keyword(s):  
Distant Metastasis ◽  
Clinicopathological Characteristics ◽  
Complete Resection ◽  
Low Grade ◽  
Mucinous Neoplasm ◽  
Node Metastasis ◽  
Appendiceal Neoplasms ◽  
Mucinous Neoplasms ◽  
Mucinous Epithelium ◽  
The Difference

Introduction: Recently, “low-grade appendiceal mucinous neoplasms” (LAMNs) have been proposed as one subtype of appendiceal mucinous neoplasms, characterized by a villous or flat proliferation of mucinous epithelium with low-grade cytologic atypia. The aim of this study was to clarify the clinicopathological characteristics of LAMN. Methods: In this multi-institutional cohort study, we retrospectively analyzed the clinicopathological characteristics in appendiceal neoplasms patients who underwent treatment from 2000 to 2017. Results: In total, 922 patients were enrolled, with 279 (30.3%) cases of LAMN, and 93 (10.1%) cases of non-LAMN disease. In comparison with patients with non-LAMN disease, those with LAMN had significantly lower levels of CA19-9 (p = 0.045), a lower frequency of T4 tumors (p < 0.0001), a lower frequency of lymph node metastasis (p < 0.0001), and a lower frequency of distant metastasis (p < 0.0001). Survival analysis revealed that patients with LAMN had a significantly better prognosis than did those with non-LAMN disease (p < 0.001). Among the patients with distant metastasis, those with LAMN had a significantly better prognosis than did those with non-LAMN disease (p = 0.0020), but among the patients without distant metastasis, the difference between the 2 groups was not significant (p = 0.26). However, among patients who underwent complete resection, the difference in prognosis between the 2 groups was not significant (p = 0.10). Conclusions: A multicenter retrospective study revealed that the clinicopathological characteristics of LAMN was different from those of non-LAMN.

scholarly journals Ductal Dilatation of ≥5 mm in Intraductal Papillary Mucinous Neoplasm Should Trigger the Consideration for Pancreatectomy: A Meta-Analysis and Systematic Review of Resected Cases

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2031
Author(s):  
Y.H. Andrew Wu ◽  
Atsushi Oba ◽  
Laurel Beaty ◽  
Kathryn L. Colborn ◽  
Salvador Rodriguez Franco ◽  
...  
Keyword(s):  
Retrospective Studies ◽  
Invasive Carcinoma ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Published Data ◽  
Intraductal Papillary Mucinous Neoplasms ◽  
Mucinous Neoplasm ◽  
Mucinous Neoplasms ◽  
Sensitivity Specificity

Intraductal papillary mucinous neoplasms (IPMN) are common but difficult to manage since accurate tools for diagnosing malignancy are unavailable. This study tests the diagnostic value of the main pancreatic duct (MPD) diameter for detecting IPMN malignancy using a meta-analysis of published data of resected IPMNs. Collected from a comprehensive literature search, the articles included in this analysis must report malignancy cases (high-grade dysplasia (HGD) and invasive carcinoma (IC)) and MPD diameter so that two MPD cut-offs could be created. The sensitivity, specificity, and odds ratios of the two cutoffs for predicting malignancy were calculated. A review of 1493 articles yielded 20 retrospective studies with 3982 resected cases. A cutoff of ≥5 mm is more sensitive than the ≥10 mm cutoff and has pooled sensitivity of 72.20% and 75.60% for classification of HGD and IC, respectively. Both MPD cutoffs of ≥5 mm and ≥10 mm were associated with malignancy (OR = 4.36 (95% CI: 2.82, 6.75) vs. OR = 3.18 (95% CI: 2.25, 4.49), respectively). The odds of HGD and IC for patients with MPD ≥5 mm were 5.66 (95% CI: 3.02, 10.62) and 7.40 (95% CI: 4.95, 11.06), respectively. OR of HGD and IC for MPD ≥10 mm cutoff were 4.36 (95% CI: 3.20, 5.93) and 4.75 (95% CI: 2.39, 9.45), respectively. IPMN with MPD of >5 mm could very likely be malignant. In selected IPMN patients, pancreatectomy should be considered when MPD is >5 mm.

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