Abstract
Background: A mucocele of the appendix is defined as a cystic luminal distention of the appendix caused by mucin. Mucoceles are an uncommon pathology and account for 0.2 to 0.4% of appendectomy specimens. Cystadenomas are the most common cause of mucoceles, representing up to 84% of the cases. The average age of presentation for mucoceles is 50 years. The clinical presentation for cystadenomas usually includes chronic or acute right lower abdominal pain, although they can be asymptomatic in 25 to 50% of the patients. The treatment for mucoceles is surgical excision, whether an appendectomy or a right colectomy is needed depends on histopathological examination and the cecum´s involvement. The 5-year survival rate for benign mucoceles is 90 to 100%. The most fearful complication for both benign and malign mucoceles is pseudomixoma peritonei. Case report: A 57-year-old male patient presented with the chief complaint of transanal bleeding and anal pain associated with defecation. We performed a colonoscopy due to the patient´s age and observed a submucosal tumor of approximately 3cm located in the cecum at the level of the appendiceal orifice. Biopsies of the region affected by the tumor revealed normal colonic mucosa. A CT scan showed a 2cm lesion dependent of the cecum. A laparoscopic hand-assisted right colectomy with oncological technique and a side-to-side ileotransverse mechanical anastomosis was performed. The final pathology report revealed an appendiceal mucinous cystadenoma with extension to the cecum. No further surgical intervention or adjuvant therapy was recommended. Highlights A mucocele is a cystic luminal distention of the appendix caused by mucin. Mucoceles account for 0.2 to 0.4% of appendectomy specimens. Surgical treatment depends on the dimensions, histology, and clinical presentation. Open surgery was indicated, nevertheless the laparoscopic approach is now accepted. Pseudomixoma peritonei is the most fearful complication for mucoceles.
Highlights
The term mucocele of the appendix implies a cystic luminal distention of the appendix caused by the accumulation of mucin [1]
A 57-year-old male patient presented with the chief complaint of transanal bleeding and anal pain associated with defecation
Our patient presented with the chief complaint of transanal bleeding and anal pain associated with defecation
Summary
The term mucocele of the appendix implies a cystic luminal distention of the appendix caused by the accumulation of mucin [1]. Mucoceles account for 8 to 10% of appendiceal tumors [2-5]. Appendiceal mucoceles present with synchronous colon cancers in 19.5. Laparoscopic Hand-Assisted Right Colectomy for Appendiceal Mucinous Cystadenoma: A Case Report and Literature Review to 21.4% of the patients [8]. Benign mucoceles have a 5-year survival rate of 90 to 100% [2, 7, 8, 10, 16]. Pseudomixoma peritonei (PMP) is the most fearful complication for benign and malign mucoceles and results from the spillage of mucin secondary to appendiceal perforation [1, 9, 14]. We performed a colonoscopy and observed a submucosal tumor of approximately 3cm located in the cecum at the level of the appendiceal orifice (Fig. 1). Final pathology report revealed an appendiceal mucinous cystadenoma with extension to the cecum (Fig. 6). We performed a laparoscopic hand-assisted right colectomy with oncological technique
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