Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2014 Aug 27:15:355-60.
doi: 10.12659/AJCR.890837.

Appendiceal mucocele and pseudomyxoma peritonei; the clinical boundaries of a subtle disease

Charalampos Spyropoulos  1 , Achilleas Rentis  1 , Eleftheria Alexaki  2 , John K Triantafillidis  3 , Constantine Vagianos  1
Affiliations
Case Reports

Appendiceal mucocele and pseudomyxoma peritonei; the clinical boundaries of a subtle disease

Charalampos Spyropoulos et al. Am J Case Rep. .

Abstract

Patient: Male, 70 • Male, 84.

Final diagnosis: Appendiceal mucocele and pseudomyxoma peritonei.

Symptoms: -.

Medication: -.

Clinical procedure: -.

Specialty: Surgery.

Objective: Rare disease.

Background: Mucocele of the appendix is an uncommon cystic lesion characterized by distension of the appendiceal lumen with mucus. Most commonly, it is the result of epithelial proliferation, but it can also be caused by inflammation or obstruction of the appendix. When an underlying mucinous cystadenocarcinoma exists, spontaneous or iatrogenic rupture of the mucocele can lead to mucinous intraperitoneal ascites, a syndrome known as pseudomyxoma peritonei.

Case report: We report 2 cases that represent the clinical extremities of this heterogeneous disease; an asymptomatic mucocele of the appendix in a 70-year-old female and a case of pseudomyxoma peritonei in an 84-year-old male. Subsequently, we review the current literature focusing to the optimal management of both conditions.

Conclusions: Mucocele of the appendix is a rare disease, usually diagnosed on histopathologic examination of appendectomized specimens. Due to the existing potential for malignant transformation and pseudomyxoma peritonei caused by rupture of the mucocele, extensive preoperative evaluation and thorough intraoperative gastrointestinal and peritoneal examination is required.

PubMed Disclaimer

Figures

Figure 1
Figure 1
(A, B) CT scan indicating a well-defined appendiceal mucocele (arrows).
Figure 2
Figure 2
(A, B) Specimen of right hemicolectomy with a well-defined mucocele of the appendix (arrow indicating lumen full of mucus).
Figure 3
Figure 3
(A, B) CT scan revealing nodular peritoneal implants and mucinous ascites, indicative of pseudomyxoma peritonei. Note that the appendix is not recognized.
Figure 4
Figure 4
Mucinous fluid aspirated from the abdominal cavity of a patient with pseudomyxoma peritonei.
Figure 5
Figure 5
Specimen of omentectomy in a patient with pseudomyxoma peritonei. Extensive tumor seeding to the omentum is identified.
See this image and copyright information in PMC

References

    1. Rokitansky CF. A manual of pathological anatomy. Vol. 1855. Philadelphia (PA): Blanchard & Lea; p. 89.
    1. Ruiz-Tovar J, Teruel DG, Castiñeiras VM, et al. Mucocele of the appendix. World J Surg. 2007;31:542–48. - PubMed
    1. Aho AJ, Heinonen R, Lauren P. Benign and malignant mucocele of the appendix. Acta Chir Scand. 1973;139:392–400. - PubMed
    1. Landen S, Bertrand C, Maddern GJ, et al. Appendiceal mucoceles and pseudomyxoma peritonei. Surg Gynecol Obstet. 1992;175:401–4. - PubMed
    1. Fann JI, Vierra M, Fisher D, et al. Pseudomyxoma peritonei. Surg Gynecol Obstet. 1993;177:441–47. - PubMed

Publication types