Appendiceal mucocele with pseudomyxoma peritonei mimicking ovarian tumor with peritoneal carcinomatosis

Ayadi, Chirihan; Naggar, Amine; Andour, Hajar; Chraa, Fatima zahrae; Jerguigue, Hounayda; Latib, Rachida; Omor, Youssef

doi:10.1016/j.radcr.2022.05.028

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…Thus, AM should be considered in the differential diagnosis of women with neoplasms on ultrasound in order to choose the best surgical approach [6,8,12,18]. The gynecologist can use diagnostic laparoscopy if there is a general surgeon in the medical institution, if a mass of appendicular origin is detected.…”

Section: Discussionmentioning

confidence: 99%

Discrepancies between preoperative diagnosis of tumors and the right uterine appendage and intraoperative data. Appendiculare mucocele, which manifests itself in the form of an appendage formation. Clinical case

Sklyarovа,

Chajkivskyj,

Prykupenko

et al. 2023

UJHW

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Tumor formations of the tubes, hydrosalpinxes, pyosalpixes have a number of discrepancies in outpatient service examinations and intraoperative clinical diagnosis. Purpose - to report a unique case with discrepancies between the preoperative diagnosis (pyosalpinx, hydrosalpinx) and the intraoperative and postoperative definitive findings (appendicular tumor, mucocele). Clinical case. A 50-year-old woman, a 3-year-old Mirena IUD wearer, applied for examination for pain in the right iliac region and a slight rise in temperature to 37-37.5 over the past 10 days. The examination showed the movement of the tumor on the right up to 7-4 cm, sensitive on palpation, uterine fibroids, and appendices on the left without features. Other history, physical examination, and laboratory tests were not remarkable, and there was no leukocytosis as in inflammatory processes. Ultrasound and MRI showed neoplasms of the right appendages of 7-5-4 cm, avascular and uterine fibroids - 3 subserosal nodes of 10-5 mm each. Intraoperatively Intact 2 fallopian tubes were detected, a tumor formation of the appendix 3-2-3 cm without adhesions was isolated. Laparoscopic appendectomy was performed along with conservative myomectomy and bilateral salpingectomy. Histopathology showed mucocele without atypia, myomas nodules, and fallopian tubes without features. Conclusions. In the formation of the right appendages of the uterus, a thorough preoperative diagnosis is required, which does not always give a definitive answer to the clinical diagnosis. Diagnostic laparoscopy, visual and operational clinical experience of the surgeon, cytological and histological examination of intra- and postoperative results make it possible to carry out adequate surgical treatment. Patients should be informed about doubts between outpatient and intraoperative diagnosis, possible changes in the intraoperative surgical plan. Prompt care should be provided in institutions with appropriate teams and equipment. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

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Section: Discussionmentioning

confidence: 99%

Discrepancies between preoperative diagnosis of tumors and the right uterine appendage and intraoperative data. Appendiculare mucocele, which manifests itself in the form of an appendage formation. Clinical case

Sklyarovа,

Chajkivskyj,

Prykupenko

et al. 2023

UJHW

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“…A literature review of the PubMed/MEDLINE, Google Scholar, and Web of Science databases from 2000 to 2022 as searches of Science Citation Index (SCI) and Scopus journals revealed similar cases of appendiceal mucocele mimicking adnexal lesions, as summarized in Table 1 [2,4,[7][8][9][10][11][12][13][14]. A total of 18 cases of tumors originating from the appendix were preoperatively diagnosed as tumors originating from the adnexa.…”

Section: Discussionmentioning

confidence: 99%

Appendiceal mucocele masquerading as an epithelial borderline ovarian tumor: a case report and literature review

Kim

Yun

Hong

et al. 2022

Korean J Clin Oncol

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Appendiceal mucocele is a rare mucin-producing neoplasm of appendiceal origin. Due to its location and imaging findings, appendiceal mucocele is easily confused with tumors of the right adnexa. We present a rare case of a patient initially misdiagnosed with an ovarian tumor intraoperatively diagnosed as an appendiceal mucocele and successfully treated. A 66-year-old postmenopausal woman was admitted to the gynecology department for an asymptomatic pelvic mass. Preoperative pelvic imaging showed an 8-cm cystic mass. Exploratory laparoscopy for the suspected epithelial borderline tumor from the right ovary revealed a cystic mass in the right pelvic area and normal uterus, fallopian tubes, and ovaries. Intraoperative consultation with the general surgery department confirmed the appendiceal origin. Laparoscopic appendectomy was performed. Histopathological examination confirmed a low-grade mucinous neoplasm of appendiceal origin. The patient was discharged on a postoperative day 5 without complications. The outpatient follow-up performed 1 month later showed no evidence of disease progression. Despite the use of advanced diagnostic tools, appendiceal mucocele may be confused for ovarian malignancies. Because the clinical features of appendiceal mucocele are nonspecific, clinicians and radiologists know the specific imaging findings. A multidisciplinary approach including general surgery, gynecology, and radiology is required for preoperative diagnosis and treatment.

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“…Ayadi [18] reinforced the idea that mucocele of the appendix with pseudomyxoma peritonei is an uncommon condition that might display ambiguous signs. Having a preoperative diagnosis is crucial for guiding proper treatment and reducing the risk of problems during and after surgery.…”

Section: Appendiceal Mucocele With Peritoneal Dissemination Mimicking...mentioning

confidence: 94%

“…A unilateral condition with intratumoral fat and a reduced appendix size may indicate the presence of OTAMT. According to a study by Ayadi [18], ultrasonography and CT scans are recommended for thorough examination, with abdominal MRI being a helpful technique for finding uncertain appendix abnormalities; these investigations should help in the orientation of a differential diagnosis between an appendiceal mucocele with PMP and a malignant ovarian tumor with peritoneal carcinomatosis. As appendiceal mucinous neoplasms with PMP are uncommon and may resemble ovarian tumors, Kostov [44] found that patients presenting with right pelvic masses should be evaluated for appendiceal tumors as part of the differential diagnosis.…”

Section: Imaging Findings Diagnosis and Differential Diagnosismentioning

confidence: 99%

Ovarian Causes of Pseudomyxoma Peritonei (PMP)—A Literature Review

Ionescu,

Marincas,

Madge

et al. 2024

Cancers

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Background. Pseudomyxoma peritonei (PMP) is a rare, progressive, slowly growing, inadequately understood neoplasm with a 5-year progression-free survival rate of as low as 48%. It is characterized by varying degrees of malignancy and the production of mucinous and gelatinous structures. Typically, the development of pseudomyxoma peritonei is associated with the rupture of appendiceal mucinous tumors and other gastrointestinal or ovarian mucinous tumors. The goal of our literature review was to identify various aspects that characterize the ovarian causes of pseudomyxoma peritonei. Materials and methods. The authors performed an extensive literature search between 1 February 2024 and 2 March 2024 on the following databases: Pubmed, Scopus, Oxford Journals, and Reaxys, and the findings were summarized into seven main clinical and paraclinical situations. Results. According to our research, the main instances in which pseudomyxoma peritonei can be triggered by an ovarian cause are the following: (1) mucinous cystadenoma; (2) mucinous ovarian cancer; (3) colon cancer with ovarian metastasis; (4) malignant transformation of an ovarian primary mature cystic teratoma; (5) appendiceal mucocele with peritoneal dissemination mimicking an ovarian tumor with peritoneal carcinomatosis; (6) mucinous borderline tumor developing inside an ovarian teratoma; and (7) the association between a mucinous bilateral ovarian cancer and a colonic tumor. Conclusions. In our study, we aimed to provide a comprehensive overview of the ovarian causes of pseudomyxoma peritonei, including its epidemiology, imagery characteristics, symptoms, current treatment, and promising future therapies, in the hopes of finding feasible solutions, as a lack of understanding of this mucus-secreting malignant disease increases the risk of delayed diagnosis or uncontrolled deterioration.

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Appendiceal mucocele with pseudomyxoma peritonei mimicking ovarian tumor with peritoneal carcinomatosis

Cited by 4 publications

References 8 publications

Discrepancies between preoperative diagnosis of tumors and the right uterine appendage and intraoperative data. Appendiculare mucocele, which manifests itself in the form of an appendage formation. Clinical case

Discrepancies between preoperative diagnosis of tumors and the right uterine appendage and intraoperative data. Appendiculare mucocele, which manifests itself in the form of an appendage formation. Clinical case

Appendiceal mucocele masquerading as an epithelial borderline ovarian tumor: a case report and literature review

Ovarian Causes of Pseudomyxoma Peritonei (PMP)—A Literature Review

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