Mucineus cystadenoma of the appendix presenting as hydrosalpinx—a pitfall in gynaecological medical imaging

Abstract

Mucinous cystadenomas of the appendix represent a very small proportion of the appendiceal pathology, yet, they can lead to a life-threatening condition, such as pseudomyxoma peritonei (PMP), if the diagnosis is delayed. Due to the tubular shape and the proximity of the right adnex, the misdiagnosis of a hydrosalpinx, a condition much more common in women and not requiring an immediate intervention, could be made. We describe a case of a 19-year-old girl presenting with symptoms of acute low abdominal pain. According to the medical imaging (ultrasound and magnetic resonance), a torsion of known chronic hydrosalpinx was suspected and an urgent laparoscopy was performed revealing, surprisingly, an enlarged appendix. Laparoscopic appendectomy was performed without difficulty. The pathology report identified a mucinous cystadenoma. Despite the recent evolution of medical imaging techniques, a misdiagnosis of the nature of a pelvic mass is still possible, leading, occasionally, to the delay of an appropriate treatment. In any case of doubt, a diagnostic laparoscopy should be performed as a golden standard in the diagnosis and management of pelvic adnexal masses in women.