Appendicular mass with pseudomyxoma peritonei: a case report

Abstract

Pseudomyxoma peritonei is an infrequently occurring clinical entity having an annual incidence of less than two per million. It is originated from the rupture of a tumour filled with mucinous substance. The intra-abdominal viscera are usually covered with a jelly-like substance. This syndrome originates most frequently from tumours of the appendix or ovaries. Genetic history is expected to play a role in the appendicular mucocele. The disease advances due to the presence of microbial agents expressed in carcinomas associated with gelatinous ascites. It typically has an insidious onset with a non-exclusive presentation like an increase in abdominal girth and associated abdominal pain with locoregional dissemination initially and dissemination to multiple sites later. The main sign is pelvic ascites. Diagnosis is made by combining radiological imaging with histopathology. Ultrasound aids in identifying the pelvic mass, peritoneal implants, calcifications, effusion, septa, the associated tumours (e.g., ovaries), the involvement of mesentery, and finalizing the surgical strategy. Usually, this condition is adequately treated by combining surgical excision and/or hyperthermic intra-peritoneal chemotherapy (HIPEC), which may be omitted by selecting the patient carefully.