Abstract
A 68-year-old female presented to the Gynecologic Oncology Clinic with a right-lower quadrant abdominal mass 3 × 4 cm in diameter palpable on pelvic examination. Her routine laboratory tests were normal. Transvaginal ultrasonography revealed a cystic mass in the right adnexa 3.9 cm in diameter, which was thought to arise in the ovary. At the time of laparoscopy, a 3 × 4 cm tumor arising from the distal end of the appendix was noted. A laparoscopic appendectomy with tumor removal was performed. Histologic examination of the surgical specimen revealed a mucocele of the appendix (AM). Although rare, this tumor should be considered in the differential diagnosis of a right adnexal mass. These tumors can be identified laparoscopically and removed by minimally invasive surgery.
Highlights
Appendiceal mucocele (AM) is a rare entity that can present in a variety of ways
Appendiceal mucocele was first described by Rokitanski in 1842, and the term refers to dilatation of the appendiceal lumen by an abnormal accumulation of mucus [1]
Mucoceles are histologically subdivided into four types based on the following classification introduced by the World Health Organization [2]: (1) retention mucocele or obstructive form of mucocele defined as cystic dilatation of the distal appendix with accumulation of abnormal mucoid material in the appendiceal lumen secondary to appendiceal outflow obstruction, (2) mucinous cystadenoma defined as a dilated mucus/ mucin-filled appendix containing adenomatous mucosa lined by atypical mucinous epithelium containing basal nuclei and showing only minimal dysplastic features, (3) mucinous cystadenocarcinoma defined as adenocarcinoma associated with mucus-filled cystic dilatation of the appendix presenting as a mucocele, (4) myxoglobulosis defined as cystic dilatation of the appendix associated with mucinous globoid bodies
Summary
Appendiceal mucocele (AM) is a rare entity that can present in a variety of ways. Appendiceal mucocele was first described by Rokitanski in 1842, and the term refers to dilatation of the appendiceal lumen by an abnormal accumulation of mucus [1]. (1) retention mucocele or obstructive form of mucocele defined as cystic dilatation of the distal appendix with accumulation of abnormal mucoid material in the appendiceal lumen secondary to appendiceal outflow obstruction,. (2) mucinous cystadenoma defined as a dilated mucus/ mucin-filled appendix containing adenomatous mucosa lined by atypical mucinous epithelium containing basal nuclei and showing only minimal dysplastic features,. (3) mucinous cystadenocarcinoma defined as adenocarcinoma associated with mucus-filled cystic dilatation of the appendix presenting as a mucocele,. (4) myxoglobulosis defined as cystic dilatation of the appendix associated with mucinous globoid bodies
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