'It's just a mucocele': a case report of a massive appendiceal mucocele presenting as a left upper quadrant mass

Abstract

Tumours of the appendix are very rare tumours that can and often present with a mucocele. This is a case report highlighting the associated pathology of appendix tumours and the management of a large mucocele. Specifically, how a right hemicolectomy is very rarely needed in these cases regardless of size and local anatomical relationships and some important considerations for the practicing surgeon in the non-tertiary centre that encounters a case like this.

Figure 1

(a,b) Computed tomography scans showing a fluid-filled left upper quadrant that displaces the stomach, whole of the small bowel, spleen and kidney (a). Multiseptated collection, representing a massive appendiceal mucocele (b) coronal section of the same CT scan highlighting displacement of the stomach, spleen small bowel and kidney. (c) Intraoperative image highlighting a normal appendix base despite massive size and pseudomyxoma peritonei indicating there is rarely any need for right hemicolectomy at the time of index surgery. (d) Resected specimen showing size and a bird’s-eye view highlighting the en-bloc colon (yellow) with the rest being mucocele.