Appendiceal Mucocele in Differential Diagnosis of Tumors in Pelvic Region

Czech version

Authors: E. Křepinská ¹; P. Jandík ²; M. Tomšová ³; I. Kalousek ¹; J. Špaček ¹
Authors‘ workplace: Porodnická a gynekologická klinika Lékařské fakulty Univerzity Karlovy a Fakultní nemocnice, Hradec Králové, přednosta doc. MUDr. J. Tošner, CSc. ¹; Chirurgická klinika Lékařské fakulty Univerzity Karlovy a Fakultní nemocnice, Hradec Králové, přednosta doc. MUDr. A. Ferko, CSc. ²; Fingerlandův ústav patologie Lékařské fakulty Univerzity Karlovy a Fakultní nemocnice, Hradec Králové, přednosta prof. MUDr. A. Ryška, Ph. D. ³
Published in: Ceska Gynekol 2008; 73(4): 247-249

Overview

Objective:
To report two cases of appendiceal mucocele in patients with suspected gynecological pathology.

Design:
Case report.

Setting:
Department of Obstetrics and Gynecology, Medical Faculty of Charles University and Faculty Hospital Hradec Králové.

Subject and method:
We report two cases of appendiceal mucocele diagnosed and treated at our department.

Conclusion:
Appendiceal mucocele is a rare pathology, characterized by abnormal accumulation of mucous in appendix lumen. It is four times more common in females with a mean age of about 55 years. The pathogenesis could be neoplastic or non-neoplastic. Appendiceal mucocele with its anatomic location must be considered in terms of differential diagnosis of masses in pelvic region. Preoperative diagnosis is important, alerting the surgeon of an unintended rupture during surgery and avoiding the development of pseudomyxoma peritonei. US and CT were reported to be valuable.

Key words:
mucocele, appendix, pseudomyxoma peritonei.

Sources

1. Aho, AJ., Heininen, R., Lauren, P., et al. Benign and malignant mucocele of the appendix. Histological types and prognosis. Acta Chir Scand, 1973, 139, p. 392-400.

2. Gonzales Moreno, S., Shmookler, BM., Sugabaker, PH. Appendiceal mucocele. Contraindication to laparoscopic appendectomy. Surg Endosc, 1998, 12, p. 1177-1179.

3. Higa, E., Rosai, J., Pizzimbono, CA., et al. Mucosal hyperplasia, mucinous cystadenoma and mucinous cystadenocarcinoma of the appendix. A re-evaluation of appendiceal „mucocele“. Cancer, 1973, 32, p. 1525-1541.

4. Horgan, J., Chow, P., Richter, J., et al. CT and sonography in the recognition of mucocele of the appendix. Am J Roentgenol, 1984, 143, p. 953-962.

5. Kahn, M., Friedman, H. Mucocele of the appendix: diagnosis and surgical management. Dis Colon Rectum, 1979, 22, p. 267-269.

6. Lam, CW., Kuo, SJ., Chang, HC., et al. Pseudomyxoma peritonei, origin from appendix: Report of cases with images. Int Surg, 2003, 88, p. 133-136.

7. Merran, S. Tumeur muco-secrétante de l@appendice ( mucocéle appendiculaire). Presse Med, 1997, 26, p. 933.

8. Pickhardt, PJ., Levy, AD., Rohrmann, CA., et al. Primary neoplasms of the appendix: radiologic spectrum of disease with pathologic correlation. Radiographics, 2003, 23, p. 645-662.

9. Pitiakoudis, M., Argyropoulou, PI., Tsaroucha, AK., et al. Cystadenocarcinoma of the appendix: an incidental imaging finding in a patient with adenocarcinomas of the ascending and the sigmoid colon. BMC Gastroenterol, 2003, 3, p. 30.

10. Price, B., McGee, JOD., Isaacson, P., Wright, N. Textbook of pathology: pathology of systems. Oxford: Oxford medical, 1992.

11. Ronnett, BM., Zahn, CM., Kurman, RJ., et al. Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis: a clinicopathologic analysis of 109 cases with emphasis on distinguishing pathologic features, site of origin, prognosis and relationship to „pseudomyxoma peritonei“. Am J Surg Pathol, 1995, 19, p. 1390-1408.

12. Sasaki, K., Ishida, H., Komatsuda, T., et al. Appendiceal mucocele: Sonographic findings. Abdom Imaging, 2003, 28, p. 15-18.

13. Stocchi, L., Wolff, BG., Larson, DR., et al. Surgical treatment of appendiceal mucocele. Arch Surg, 2003, 138, p. 585-589.

14. Tanioka, C., Haruma, K., Sumii, K., et al. A case of mucocele of the appendix diagnosed by medical images. Nippon Shokakibyo Gakkai Zasshi, 1987, 84, p. 1679-1683.

15. Zissin, R., Gayer, G., Kots, E., et al. Imaging of mucocele of the appendix with emphasis on the CT findings: A report of 10 cases. Clin Radiol, 1999, 54, p. 826-832.