Low Grade Appendiceal Mucinous Neoplasm with Pseudomyxoma Peritonei: An Enigma for Pathologist.

Veena Maheshwari,Kiran Alam,Feroz Alam,Nishat Afroz

doi:10.5005/jp-journals-10018-1115

Abstract

ABSTRACTMalignant mucinous neoplasms of the appendix is an infrequently encountered entity. Extra-appendiceal spread of these tumor is one of the commonest etiology of pseudomyxoma peritonei, which demands a hightened vigilance in their early diagnosis. Although low-grade appendiceal mucinous neoplasms (LAMNs) largely stay confined to the appendix, but they can spread to the peritoneum as pseudomyxoma peritonei leading to an unpredictable outcome. Due to the rare occurrence of low-grade appendiceal neoplasm only tenuous and limited information is present in the medical literature. We report a case of LAMN with pseudomyxoma peritonei in a 45-year-old male, who presented with the complaints of abdominal distension associated with abdominal pain and constipation. Clinical examinations and computed tomography (CT) scan were suggestive of pseudomyxoma peritonei. Peroperative findings and histopathological examination rendered a conclusive diagnosis of low-grade appendiceal neoplasm.How to cite this article: Qadri S, Alam K, Alam F, Maheshwari V. Low Grade Appendiceal Muci-nous Neoplasm with Pseudomyxoma Peritonei: An Enigma for Pathologist. Euroasian J Hepato-Gastroenterol 2014;4(2):113-116.

Highlights

INTRODUCTIONLow-grade appendiceal mucinous neoplasms (LAMNs) are rare condition with the reported prevalence of less than 1% of all appendectomies.[1]
Low-grade mucinproducing tumors of the appendix that includes adenomas and mucinous tumors of unknown malignant potential (MTUMP) may present with pseudomyxoma peritonei due to their potential to spread to the peritoneal cavity and viscera in the form of mucinous deposits.[2]
We hereby report this uncommon case of Low-grade appendiceal mucinous neoplasms (LAMNs) as it bespeak the potential of this tumor to spread to the peritoneal cavity causing pseudomyxoma peritonei that would lead to a disastrous clinical outcome

Summary

INTRODUCTION

Low-grade appendiceal mucinous neoplasms (LAMNs) are rare condition with the reported prevalence of less than 1% of all appendectomies.[1]. Computed tomography (CT) scan revealed scalloping of visceral surface and hyperdense mucinous ascites filling the peritoneal cavity, bowel loops showing external compression by peritoneal implants, appendix was not visualized (Figs 1A and B). The appendix was received as a small tubular structure of 2 × 1 cm attached to a ruptured distorted mass measuring 7 × 6 × 1 cm (Fig. 2A) with abundant mucin adhered to the mucosal as well as serosal surface. The patient was discharged after a week stay in hospital in a satisfactory condition

DISCUSSION

Mucinous adenocarcinoma

Findings

CONCLUSION