Abstract
BackgroundMucoceles resulting from cystadenomas of the appendix are uncommon. Although rare, rupture of the mucoceles can occur with or without causing any abdominal complaint. There are several reports associating colonic malignancy with cystadenomas of the appendix. Herein, we report an unusual and interesting case of right inguinal hernia associated with left colon cancer.Case presentationA case of ruptured mucocele resulting from cystadenoma of the appendix was presented as right inguinal hernia in a 70-year-old male. The patient underwent colonoscopy, x-ray, ultrasound and computed tomography. Localized pseudomyxoma peritonei associated with adenocarcinoma of the descending colon was diagnosed. The patient underwent segmental resection of the colon, appendectomy, debridement of pseudomyxoma and closure of the internal ring of right inguinal canal. He is free of symptoms in one year follow-up.ConclusionSynchronous colon cancer may occur in patients with appendiceal mucoceles. In such patients, the colon should be investigated and colonoscopy can be performed meticulously in cases of ruptured mucoceles and localized pseudomyxoma peritonei. Surgical intervention is the current choice of management.
Highlights
Mucoceles resulting from cystadenomas of the appendix are uncommon
We present a very unusual case of ruptured cystadenoma of the appendix with localized pseudomyxoma peritonei presenting as right inguinal hernia in a patient with left colon cancer
The right inguinal canal was occupied by a heterogenous lesion with adjacent fat stranding suggestive of appendiceal mucocele with rupture(Figure 2)
Summary
Synchronous colon cancer may occur in patients with appendiceal mucoceles. In such patients, the colon should be investigated. In patients with ruptured mucoceles and localized pseudomyxoma peritonei, the colonoscopy can be performed meticulously. Surgery is the recommended method of treatment. AFitgluapraero6tomy, the appendix was excised and the pieces were removed At laparotomy, the appendix was excised and the pieces were removed. TFhigeulroew7er peritoneal cavity and the right inguinal canal were filled with yellowish gelatinous fluid The lower peritoneal cavity and the right inguinal canal were filled with yellowish gelatinous fluid. MsnFtoirigcuaurtsoercdseycsdo8tipaladicteantllioyo,mntahaendmcuocnotsaainl ignlagnmdsucoifntshueggaepspteivnedioxfdmeumcoi-nMicroscopically, the mucosal glands of the appendix demonstrated dilatation and containing mucin suggestive of mucinous cystadenoma. The periappendix tissue showed mucinous tissue mixed with granulation tissue without tumor in it and consistent with pseudomyxoma peritonei
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