Appendiceal Mucocele Presenting as a Right Adnexal Mass: A Case Report

Abstract

A 68-year-old female presented to the Gynecologic Oncology Clinic with a right-lower quadrant abdominal mass 3 × 4 cm in diameter palpable on pelvic examination. Her routine laboratory tests were normal. Transvaginal ultrasonography revealed a cystic mass in the right adnexa 3.9 cm in diameter, which was thought to arise in the ovary. At the time of laparoscopy, a 3 × 4 cm tumor arising from the distal end of the appendix was noted. A laparoscopic appendectomy with tumor removal was performed. Histologic examination of the surgical specimen revealed a mucocele of the appendix (AM). Although rare, this tumor should be considered in the differential diagnosis of a right adnexal mass. These tumors can be identified laparoscopically and removed by minimally invasive surgery.

Case of idiopathic and complete appendiceal intussusception

“…There have been several reports on surgical treatment of appendix intussusception. The laparoscopic approach is advantageous because it allows observation within the entire abdominal cavity and minimizes physical contact with possible malignancies . In this case, appendectomy was the most minimally invasive procedure.…”

Appendiceal mucocele and peritoneal inclusion cyst mimicking right adnexal masses: a diagnostic challenge in gynecologic practice

“…The differential diagnosis includes adnexal and appendiceal tumors [5,6]. MA is characterized by abnormal mucus accumulation and dilatation of the lumen of the vermiform appendix [7].…”

“…Therefore, a histopathologic microphotograph of the accumulated mucin in the appendiceal lumen is needed for its definitive diagnosis. The most common presenting signs and symptoms of patients with this entity are right lower quadrant abdominal pain (27 %), abdominal mass (16 %), weight loss (10 %), and change in bowel habits (5 %) [5]. These, however, are nonspecific, and thus diagnosis of MA can never be made based on them alone.…”

“…Although there have been many case reports of MA mimicking an adnexal mass [5,7,11,12], the diagnosis could be made only at the time of surgery in all of the cases. O'connor et al [10] reported a case with PIC complicated by appendicitis and mentioned that PIC involving appendicitis is very rare.…”

Large Mucocele of the Appendix at Laparoscopy Presenting as an Adnexal Mass in a Postmenopausal Woman: A Case Report

“…Mucocele of the appendix is a rare pathology with an incidence of approximately 0.2 to 0.3% of all appendicectomy specimens [ 1 – 4 ]. Mucocele of the appendix was first described by Rokitansky in 1842.…”