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Appendix mucocele: a case report

Year 2012, Volume: 18 Issue: 1, 42 - 45, 01.02.2012

Abstract

Mucocele of the appendix is a rare entity, characterized by distention of the lumen due to collection of mucoid material. In this case, our aim is to report a mucocele of appendix with computed tomography (CT) findings. A 46-year old male presented to our department with abdominal pain and decreased appetite. Ultrasonography (US) and CT were performed. A tubular cystic mass was detected with US. On contrast enhanced abdomen CT, a nonenhanced cystic mass, measured 4x9cm, was detected at the right lower quadrant near cecum. Radiologic diagnosis was appendix mucocele. By this diagnosis laparoscopy was performed. A mass located at the right low quadrant near cecum was seen. Because of the big size of mass and possible perforation risk laparoscopy was converted to open laparotomy. Mass was excised without perforation. The pathologic diagnosis was mucinous cystadenoma, and there was no malignity evidence. The postoperative course was unremarkable, so he was discharged at the 3rd day postoperatively. Mucocele should be kept in mind as a differential diagnosis of appendix mass. During the operation, surgeon should be aware of possible risk of perforation and pseudomixoma peritonei.

References

  • 1. Carr NJ, McCarthy WF, Sobin LH. Epithelial noncarcinoid tumors and tumor-like lesions of the appendix: a clinicopathologic study of 184 patients with a multivariate analysis of prognostic factors. Cancer 1995;75(3):757-68
  • 2. Stocchi L, Wolff BG, Larson DR, Harrington JR. Surgical treatment of appendiceal mucocele. Arch Surg 2003;138(6):585-9
  • 3. Pickhardt PJ, Levy AD, Rohrmann CA Jr, Kende AI. Primary neoplasms of the appendix: radiologic spectrum of disease with pathologic correlation. Radiographics 2003;23(3):645-62
  • 4. Isaacs KL, Warshauer DM. Mucocele of the appendix: computed tomographic, endoscopic, and pathologic correlation
  • Am J Gastroenterol 1992;87(6):787-9
  • 5. Chiou YY, Pitman MB, Hahn PF, Kim YH, Rhea JT, Mueller PR. Rare benign and malignant appendiceal lesions: spectrum of computed tomography findings with pathologic correlation. J Comput Assist Tomogr 2003;27(3):297-306
  • 6. Caspi B, Cassif E, Auslender R, Herman A, Hagay Z, Appelman Z. The onion skin sign: a specific sonographic marker of appendiceal mucocele. J Ultrasound Med 2004;23(1):117-21
  • 7. Güler SA, Özmen T, Aktan AÖ. Appendiks mukoseli ve laparoskopik tedavisi. Ulusal Cerrahi Dergisi 2010:26(4):216-9
  • 8. Misdraji J, Yantiss RK, Graeme-Cook FM, Balis UJ, Young RH. Appendiceal mucinous neoplasms: a clinicopathologic analysis of 107 cases. Am J Surg Pathol 2003;27(8):1089-103
  • 9. Dhage-Ivatury S, Sugarbaker PH. Update on the surgical approach to mucocele of the appendix. J Am Coll Surg 2006;202(4):680-4
  • 10. Lau H, Yuen WK, Loong F, Lee F. Laparoscopic resection of an appendiceal mucocele. Surg Laparosc Endosc Percutan Tech 2002;12(5):367-70
  • 11. Gonzalez-Moreno S, Sugarbaker PH. Right hemicolectomy does not confer a survival advantage in patients with mucinous carcinoma of the appendix and peritoneal seeding. Br J Surg 2004;91(3):304-11
  • 12. Long J, Yang F, Jin C, Fu DL. Mucocele of the appendix. Dig Surg 2009;26(2):115-6

Appendiks mukoseli: olgu sunumu

Year 2012, Volume: 18 Issue: 1, 42 - 45, 01.02.2012

Abstract

Appendiks mukoseli, appendiks lümeninin mukusla dolması sonucu obstrüktif dilatasyonuyla karakterize nadir bir hastalıktır. Bu olgu sunumunda nonspesifik şikayetlerle başvuran hastada saptanan appendiks mukoselini bilgisayarlı tomografi (BT) görüntüleri eşliğinde sunmayı amaçladık. 46 yaşında erkek hasta hafif karın ağrısı ve iştahsızlık şikayetleri ile hastanemize başvurdu. Hastaya ultrasonografi (US) ve sonrasında BT yapıldı. US'de appendiks lojunda yoğun içerikli tubuler yapıda kistik kitle saptandı. Abdomene yönelik oral ve intravenöz opak sonrası yapılan BT'de appendiks lojunda 4x9 cm boyutlu tübüler yapıda, heterojen su dansitesinde belirgin kontrastlanma göstermeyen kitle saptandı. Radyolojik tanı mukosel ile uyumluydu. Hasta bu ön tanıyla laparoskopiye alındı. Sağ alt kadranda çekum komşuluğunda, appendiks lojundaki kitle görüldü. Kitlenin boyutunun büyük olması ve appendiks mukosellerinde tanımlanmış olan perforasyon riski nedeniyle laparotomi yapıldı. Kitle disseke edilerek çekumdan ayrıldı ve perfore edilmeden çıkarıldı. Patolojik tanı müsinöz kistadenoma bağlı mukoseldi. Patolojik materyalde malignite bulgusu saptanmadı. Postoperatif 3. gün hasta taburcu edildi. Tedavinin doğru bir şekilde yönlendirilebilmesi için appendiks kitlelerinde mukosel, ayırıcı tanıda akılda tutulmalıdır. Bu hastalarda perforasyon sonucu gelişebilecek psödomiksoma peritonei riskine karşı dikkatli olunmalıdır.

References

  • 1. Carr NJ, McCarthy WF, Sobin LH. Epithelial noncarcinoid tumors and tumor-like lesions of the appendix: a clinicopathologic study of 184 patients with a multivariate analysis of prognostic factors. Cancer 1995;75(3):757-68
  • 2. Stocchi L, Wolff BG, Larson DR, Harrington JR. Surgical treatment of appendiceal mucocele. Arch Surg 2003;138(6):585-9
  • 3. Pickhardt PJ, Levy AD, Rohrmann CA Jr, Kende AI. Primary neoplasms of the appendix: radiologic spectrum of disease with pathologic correlation. Radiographics 2003;23(3):645-62
  • 4. Isaacs KL, Warshauer DM. Mucocele of the appendix: computed tomographic, endoscopic, and pathologic correlation
  • Am J Gastroenterol 1992;87(6):787-9
  • 5. Chiou YY, Pitman MB, Hahn PF, Kim YH, Rhea JT, Mueller PR. Rare benign and malignant appendiceal lesions: spectrum of computed tomography findings with pathologic correlation. J Comput Assist Tomogr 2003;27(3):297-306
  • 6. Caspi B, Cassif E, Auslender R, Herman A, Hagay Z, Appelman Z. The onion skin sign: a specific sonographic marker of appendiceal mucocele. J Ultrasound Med 2004;23(1):117-21
  • 7. Güler SA, Özmen T, Aktan AÖ. Appendiks mukoseli ve laparoskopik tedavisi. Ulusal Cerrahi Dergisi 2010:26(4):216-9
  • 8. Misdraji J, Yantiss RK, Graeme-Cook FM, Balis UJ, Young RH. Appendiceal mucinous neoplasms: a clinicopathologic analysis of 107 cases. Am J Surg Pathol 2003;27(8):1089-103
  • 9. Dhage-Ivatury S, Sugarbaker PH. Update on the surgical approach to mucocele of the appendix. J Am Coll Surg 2006;202(4):680-4
  • 10. Lau H, Yuen WK, Loong F, Lee F. Laparoscopic resection of an appendiceal mucocele. Surg Laparosc Endosc Percutan Tech 2002;12(5):367-70
  • 11. Gonzalez-Moreno S, Sugarbaker PH. Right hemicolectomy does not confer a survival advantage in patients with mucinous carcinoma of the appendix and peritoneal seeding. Br J Surg 2004;91(3):304-11
  • 12. Long J, Yang F, Jin C, Fu DL. Mucocele of the appendix. Dig Surg 2009;26(2):115-6
There are 13 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Taylan Kara This is me

Gökhan Darılmaz This is me

Mehmet Sedat Durmaz This is me

Publication Date February 1, 2012
Published in Issue Year 2012 Volume: 18 Issue: 1

Cite

APA Kara, T., Darılmaz, G., & Durmaz, M. S. (2012). Appendiks mukoseli: olgu sunumu. Gaziantep Medical Journal, 18(1), 42-45.
AMA Kara T, Darılmaz G, Durmaz MS. Appendiks mukoseli: olgu sunumu. Gaziantep Medical Journal. February 2012;18(1):42-45.
Chicago Kara, Taylan, Gökhan Darılmaz, and Mehmet Sedat Durmaz. “Appendiks Mukoseli: Olgu Sunumu”. Gaziantep Medical Journal 18, no. 1 (February 2012): 42-45.
EndNote Kara T, Darılmaz G, Durmaz MS (February 1, 2012) Appendiks mukoseli: olgu sunumu. Gaziantep Medical Journal 18 1 42–45.
IEEE T. Kara, G. Darılmaz, and M. S. Durmaz, “Appendiks mukoseli: olgu sunumu”, Gaziantep Medical Journal, vol. 18, no. 1, pp. 42–45, 2012.
ISNAD Kara, Taylan et al. “Appendiks Mukoseli: Olgu Sunumu”. Gaziantep Medical Journal 18/1 (February 2012), 42-45.
JAMA Kara T, Darılmaz G, Durmaz MS. Appendiks mukoseli: olgu sunumu. Gaziantep Medical Journal. 2012;18:42–45.
MLA Kara, Taylan et al. “Appendiks Mukoseli: Olgu Sunumu”. Gaziantep Medical Journal, vol. 18, no. 1, 2012, pp. 42-45.
Vancouver Kara T, Darılmaz G, Durmaz MS. Appendiks mukoseli: olgu sunumu. Gaziantep Medical Journal. 2012;18(1):42-5.