Mucocele of the appendix: appendectomy or colectomy?

Abstract

Mucocele of the appendix is a rare disease. It can be triggered by benign or malignant diseases, which cause the obstruction of the appendix and the consequent accumulation of mucus secretion. The preoperative diagnosis is difficult due to non-specific clinical manifestations of the disease. Imaging tests can suggest the diagnosis. the treatment is always surgical and depends on the integrity and size of the appendix base and on the histological type of the original lesion. the prognosis is good in cases of integrity of the appendix. the perforation of the appendix and subsequent extravasation of its contents into the abdominal cavity may lead to pseudomyxoma peritonei, which has very poor prognosis if not treated properly.

Retroperitoneal Giant Mixed Adenoneuroendocrine Carcinoma: Case Report

“…As a standard approach, although an appendectomy is considered sufficient in cases of cystadenoma or hyperplasia, in patients with cystadenocarcinoma it should be combined with a right hemicolectomy. [17,18] If there is no involvement of a neighboring mesenteric organ or peritoneal involvement, then removal of the appendix with its mesentery will suffice in cases of cystadenocarcinoma. [19] However, if there is invasion of the surrounding organs or tissues, then a right hemicolectomy is advised.…”

Giant Mucinous Cystadenoma of the Appendix With Low Grade Dysplasia Presented as Acute Appendicitis: A Case Report and Literature Review

“…The latter two are often referred to as neoplastic mucoceles. Both mucinous cystadenoma and mucinous adenocarcinoma may cause pseudomixoma peritonei, a potentially devastating complication of mucocele rupture [8,9].…”

“…Hyperplastic mucocele accounts for 5-25% of cases, mucinous cystadenoma (most common type) for 63-84%, and mucinous cystoadenocarcinoma for 11-20% of all mucoceles. Both mucinous cystadenoma and cystoadenocarcinoma are characterized by marked distention of the appendiceal lumen up to 6 cm [9,10].…”

“…The clinical presentation of appendiceal mucoceles is usually unspecific; the most common symptom is abdominal pain with or without palpable mass in RLQ [9,11]. Very large lesions could be asymptomatic up to 51% [12,13].…”

“…It is generally accepted that CT is better than ultrasound (US) and magnetic resonance imaging (MRI) to diagnose mucocele: however, it is difficult to distinguish between benign and malignant neoplastic mucoceles [9,[15][16][17]. Mucinous Appendiceal mucocele requires surgical resection.…”