Sağ adneksiyel kitleyi taklit eden apendiks müsinöz kistadenomu

Yıl 2016, , 570 - 572, 30.09.2016

Mehmet Tolga Kafadar , Bahadır Kösem Emine Kirtiş Nermin Köşüş Aydın Köşüş

https://doi.org/10.17826/cukmedj.237544

Öz

Apendiks mukoseli anormal müsinöz sekresyonlara bağlı apendiks lümeninin dilatasyonuyla oluşan kitledir. Mukosel, mukozal hiperplazi, müsinöz kistadenoma veya müsinöz kistadenokarsinoma şeklinde epitelyal proliferasyon, müsinöz sekresyon ve lüminal dilatasyon sonucunda oluşur. Apendiks müsinöz kistadenomu en sık görülen şekli olup, farklı klinik tablolarla kendini gösterebilir. Preoperatif tanısı zordur ve genellikle laparotomi sırasında tespit edilir. Rüptür riskinden dolayı mevcut endişelere rağmen, tedavide laparoskopik cerrahi giderek artan sıklıkla uygulanmaktadır. Lezyonun perfore olup içeriğinin peritoneal kaviteye yayılması sonucu psödomiksoma peritonei oluşabilir. Bu yazıda, sağ adneksiyal kitle ön tanısıyla ameliyata alınan ve laparoskopik eksplorasyonda apendiks mukoseli izlenmesi üzerine laparoskopik apendektomi yapılan 75 yaşında kadın bir olgu sunulmuştur.

Anahtar Kelimeler

Apendiks, laparaskopik apendektomi, mukosel

Appendix mucinous cystadenoma mimicking a right adnexal mass

Öz

Appendix mucocele is a mass formed by the dilatation of appendix lumen due to abnormal mucinous secretions. It develops as a result of epithelial proliferation, mucinous secretion, and luminal dilatation on the background of mucosal hyperplasia, mucinous cystadenoma, or mucinous cystadenocarcinoma. Appendix mucinous cystadenoma is the most common type that may have different clinical presentations. The preoperative diagnosis remains difficult and the pathology is usually detected during laparotomy. Despite concerns about the rupture risk of appendix mucoceles, laparoscopic surgery has been increasingly used for its treatment. Perforation of a lesion and spread of its contents into abdominal cavity produces a condition known as pseudomyxoma peritonei. In this paper we report a case of 75-year-old woman who was taken to the operating room to be operated for a right adnexial mass and but ultimately underwent laparoscopic appendectomy after detecting an appendix mucocele in laparoscopic exploration.

Anahtar Kelimeler

Appendix, laparoscopic appendectomy, mucocele

Kaynakça

• Shukunami K, Kaneshima M, Kotsuji F. Preoperative diagnosis and radiographic findings of a freely movable mucocele of the vermiform appendix. Can Assoc Radiol J. 2000;51:281-2.
• Rampone B, Roviello F, Marrelli D, Pinto E. Giant appendiceal mucocele: Report of a case and brief review. World J Gastroenterol. 2005;11:4761-3.
• Carr NJ, Mc Carthy 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;75:757-68.
• Minni F, Petrella M, Morganti A, Santini D. Giant mucocele of the appendix. Dis Colon Rectum. 2001;44:1034-6.
• Coulier B, Pestieau S, Hamels J, Lefebvre Y. US and CT diagnosis of complete cecocolic intussusception caused by an appendiceal mucocele. Eur Radiol. 2002;12:324-8.
• 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;23:117-21.
• Pickhardt PJ, Levy AD, Rohrmann CA Jr, Kende AI. Primary neoplasms of the appendix: radiologic spectrum of disease with pathologic correlation. Radiographics. 2003;23:645-62.
• Pitiakoudis M, Tsaroucha AK, Mimidis K, Polychronidis A, Minopoulos G, Simopoulos C. Mucocele of the appendix: a report of five cases. Tech Coloproctol. 2004;8:109-12.
• Chiu CC, Wei PL, Huang MT, Wang W, Chen TC, Lee WJ. Laparoscopic resection of appendiceal mucinous cystadenoma. J Laparoendosc Adv Surg Tech A. 2005;15: 325-8.
• Rangarajan M, Palanivelu C, Kavalakat AJ, Parthasarathi R. Laparoscopic appendectomy for mucocele of the appendix: report of 8 cases. Indian J Gastroenterol. 2006;25:256-7.