A CASE OF MUCINOUS CYSTADENOMA OF THE APPENDIX WITH HIGH SERUM CEA LEVEL

Abstract

The appendix mucocele is a rare disease and often presents difficulty in diagnosis before operation. We experienced a case of mucinous cystoadenoma of the appendix with high serum CEA level. A 74-year-old man was admitted to the hospital because of severe dizziness due to melena. When a mass was palpable in the right lower abdominal quadrant. Gastro and colonofiberscopies revealed no cause of melena but a SMT like elevation in the cecum. Barium enema examination showed the extraluminal compression of the ascending colon, but the appendix could not be visualized. A cystic mass contacted with the right kidney was revealed by ultrasonography and CT scan. The renal cell carcinoma was suspected by fine needle aspiration biopsy. Suspected of malignancy with the high level of serum CEA, right hemicolectomy and right nephrectomy with lymph nodes dissection were performed. Histological, the tumor was mucinous cystadenoma of the appendix with no severe atypical cell. Melena was from ileal ulcer which was included in the resected lesion. After the operation, the serum CEA has smoothly fallen to normal level. This disease may result in pseudomyxoma peritonei with poor prognosis. Here the importance of the complete resection so as not to lose the time after diagnosis is emphasized.