Incidentally discovered low-grade appendiceal mucinous neoplasm: a precursor to pseudomyxoma peritonei

Abstract

Appendiceal mucoceles (AMs) infrequently arise from an underlying malignancy. Treatment has progressed toward a less aggressive approach over time; they can be managed by appendectomy-only unless pathology reveals malignancy. The ultimate goal of management is to prevent AM rupture, avoiding the syndrome of pseudomyxoma peritonei.

Keywords: Appendiceal mucinous neoplasm; appendix; mucinous cystadenoma; mucocele; pseudomyxoma peritonei.

Figure 1

Contrast‐enhanced computed tomography image of the abdomen and pelvis showing a well‐circumscribed, fluid‐dense cystic mass measuring 8.5 × 4.3 × 4.1 cm and absence of findings associated with PMP.

Figure 2

Forceps identifying the distended distal appendix (9 × 4.2 cm) visualized on the operative field.

Figure 3

Resected specimen with incised appendix revealing viscous, mucoid material.

Figure 4

Section of the appendiceal margin showing goblet cells and lumen distended by mucin (H&E, 10x).

Figure 5

Section of the thinned appendiceal wall secondary to luminal distension by mucin with hyalinization. (H&E, 10x).