Low‐grade appendiceal mucinous neoplasm with disseminated peritoneal adenomucinosis involving the uterus, mimicking primary mucinous endometrial adenocarcinoma: A case report

Tanaka, Hirohiko; Kobayashi, Takumi; Yoshida, Kayo; Asakura, T; Taniguchi, Haruki; Mikami, Yoshiki

doi:10.1111/j.1447-0756.2011.01585.x

Cited by 15 publications

(10 citation statements)

References 9 publications

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“…Samet et al (4) reported a case similar to Moore's second case, in that epithelium histologically and immunohistochemically consistent with intestinal derivation was admixed with normal endometrial and endocervical epithelium on microsopic examination of the uterus of a patient with known LAMN. Tanaka et al (5) reported a case with similar findings but with invasion of the myometrium in a woman with a diagnosis of LAMN several years earlier. In all of these cases, the differential diagnosis is between secondary involvement by LAMN, a primary intestinal-type neoplasm at these sites, or possibly intestinal metaplasia in the noninvasive cases.…”

Section: Pseudomyxoma Endometriimentioning

confidence: 62%

“…Much more rarely, spread of LAMN to other gynecologic sites has been reported, including the fallopian tubes (7), endometrium, and endocervix (3)(4)(5).…”

Section: Pseudomyxoma Endometriimentioning

confidence: 99%

“…The term pseudomyxoma ovarii is commonly used for the same finding involving the surface of the ovary, a common site of spread for these tumors. Very rarely, pseudomyxoma affects other gynecologic sites, including the endometrium (3)(4)(5).…”

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confidence: 99%

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“Pseudomyxoma Endometrii”

Shaw

Kokh²,

Ioffe³

et al. 2015

International Journal of Gynecological Pathology

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Low-grade appendiceal mucinous neoplasms (LAMNs) are commonly associated with deposition of mucin, with or without admixed low-grade epithelium, on peritoneal surfaces (pseudomyxoma peritonei). We describe a very rare presentation of LAMN as extensive mucin deposition in the endometrium of a 43-yr-old woman initially mistaken for a primary uterine myxoid neoplasm. The patient underwent endometrial curettage that demonstrated abundant myxoid/mucoid material interspersed with small vessels, bland eosinophilic spindled cells, scattered foci of typical endometrial stroma, and occasional endometrioid glands. The endometrial stroma was positive for CD10, and the eosinophilic spindled cells were positive for actin. The lesion was interpreted as "myxoid/mucinous neoplasm, most likely of smooth muscle/endometrial stromal origin." Subsequent laparotomy revealed peritoneal mucin in the anterior cul-de-sac and a dilated appendix. Pathologic review confirmed appendiceal LAMN and multifocal peritoneal mucinosis. The uterus contained scant residual mucoid material. On review of all pathologic material at our institution, the endometrial lesion was consistent with organizing mucin derived from the LAMN with entrapped benign endometrium. "Pseudomyxoma endometrii" is readily mistaken for a primary uterine myxoid neoplasm, particularly myxoid endometrial stromal tumor. A key to diagnosis is recognition that the material is mucin rather than myxoid stroma. This is evidenced by the absence of embedded stromal cells and presence of myofibroblastic, vascular, and macrophage infiltration associated with organization. Epithelium containing goblet cells is an important clue if present. The presence of rare endometrial glands within the endometrial stroma suggests that the latter is entrapped rather than neoplastic.

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Section: Pseudomyxoma Endometriimentioning

confidence: 62%

“…Much more rarely, spread of LAMN to other gynecologic sites has been reported, including the fallopian tubes (7), endometrium, and endocervix (3)(4)(5).…”

Section: Pseudomyxoma Endometriimentioning

confidence: 99%

See 1 more Smart Citation

“Pseudomyxoma Endometrii”

Shaw

Kokh²,

Ioffe³

et al. 2015

International Journal of Gynecological Pathology

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“…Th e plethora of confl icting evidence in literature [7][8][9][10][11][12][13][14][15][16][17] and the reconciliation with the fact that both tumors appear similar in morphology and IHC expression regardless of origin raises important research questions. First; if these tumors are so mysteriously similar in morphology and IHC expression, do they have a similar biological behavior?…”

Section: Discussionmentioning

confidence: 99%

Low Grade Appendiceal Mucinous Neoplasm with Concomitant Ovarian Mucinous Tumor, Mature Cystic Teratoma and Pseudomyxoma Peritonei

Murad

Mufti

2017

Saudi J Intern Med

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Low grade appendiceal mucinous neoplasms are a challenging entity not just due to their innocent appearance and aggressive extension but also due to their origin dilemmas. We present one such interesting case in a 35-year-old Saudi female who presented to King Abdulaziz University Hospital with acute abdominal pain. Th e patient presented with the main bulk of the mucinous tumor in the left ovary with extensive pseudomyxoma peritonei. Incidentally there was also a mature cystic teratoma in the same ovary. Appendiceal origin was confi rmed on histology and immunohistochemistry. In conclusion our case scenario of low grade appendiceal mucinous neoplasms with concomitant ovarian mucinous tumor, mature cystic teratoma and pseudomyxoma peritonei suggests appendiceal origin both on morphology and immunohistochemistry. As such routine excision of appendix in these case scenarios remains a valid consideration.

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“…Appendiceal adenocarcinoma, especially mucinous adenocarcinoma, is notorious for its spread to adjacent organs and forms the fistula to colon [6], uterus [7], and skin [8]. It is uncommon that an appendiceal adenocarcinoma penetrates into the bladder.…”

Section: Introductionmentioning

confidence: 99%

Combination of CT imaging and endoscopy in diagnosis of appendicovesical fistula caused by appendiceal adenocarcinoma

Wang

et al. 2014

Journal of X-Ray Science and Technology

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The appendiceal diseases, particularly appendicitis, are the most common disorders in the digestive system localized at the right lower quadrant area. However, appendiceal carcinoma with vesico-appendiceal fistula is a rare clinical phenomenon. Lacking specific symptoms, appendiceal carcinomas with fistula formations are often misdiagnosed as acute appendicitis cases. The purpose of this study is to increase awareness of appendiceal neoplasms and appendicovesical fistulas. We reported our experiences in three complex cases related to digestive and urological systems, and reviewed the literature on diagnosis with various X-ray imaging techniques for this lesion. In this report, the first case failed to be diagnosed. The other two patients with appendicovesical fistulas secondary to appendiceal adenocarcinomas were successfully detected with computed tomography (CT) and cystoscopy. The patients recovered after right hemicolectomies and en bloc partial cystectomies and survived without tumor metastasis up to 7-year follow-up. In conclusion, a combined use of CT imaging and endoscopy techniques provides an accurate diagnostic alternative for appendicovesical fistula secondary to appendiceal adenocarcinoma.

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Low‐grade appendiceal mucinous neoplasm with disseminated peritoneal adenomucinosis involving the uterus, mimicking primary mucinous endometrial adenocarcinoma: A case report

Cited by 15 publications

References 9 publications

“Pseudomyxoma Endometrii”

“Pseudomyxoma Endometrii”

Low Grade Appendiceal Mucinous Neoplasm with Concomitant Ovarian Mucinous Tumor, Mature Cystic Teratoma and Pseudomyxoma Peritonei

Combination of CT imaging and endoscopy in diagnosis of appendicovesical fistula caused by appendiceal adenocarcinoma

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