Mucinous cystadenoma and cystadenocarcinoma of the vermiform appendix with particular reference to mucocele and pseudomyxoma peritonei

Gibbs, N. M.

doi:10.1136/jcp.26.6.413

Cited by 84 publications

(28 citation statements)

References 9 publications

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“…First, neoplastic epithelium extending into a diverticulum, as well as displaced islands of neoplastic epithelium in an inflamed diverticulum, may be mistaken for invasion of the appendiceal wall by a low-grade mucinous tumor. The presence of acellular mucin within the wall of the appendix in association with these low-grade neoplasms may cause a similar diagnostic problem (8,9,21). The lack of atypical cells within dissecting mucin and the absence of desmoplasia may aid in distinguishing mucinous dissection and diverticula containing neoplastic epithelium from a truly invasive neoplasm (9).…”

Section: Discussionmentioning

confidence: 99%

The Coexistence of Low-Grade Mucinous Neoplasms of the Appendix and Appendiceal Diverticula: A Possible Role in the Pathogenesis of Pseudomyxoma Peritonei

et al. 2000

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We examined 38 appendectomies with diagnoses of mucocele, diverticulum, or adenoma to study the coincidence of appendiceal diverticula and appendiceal low-grade mucinous neoplasms and to examine the possible role of diverticula in the pathogenesis of pseudomyxoma peritonei. Invasive adenocarcinomas and retention cysts were excluded (six cases). Cases were classified as adenomas or mucinous tumors of unknown malignant potential, with or without diverticula. Medical records were reviewed for multiple parameters, including presenting symptoms, presence of pseudomyxoma peritonei, and presence of associated malignancies. Binomial statistics were used to calculate the probability that the observed prevalence of low-grade mucinous neoplasms and diverticula together was significantly different from the expected prevalence of diverticula or low-grade mucinous neoplasms alone, using historical controls from the literature.Twenty-five percent of the total cases (8 of 32) contained both a low-grade mucinous neoplasm (7 cystadenomas and 1 mucinous tumor of unknown malignant potential) and a diverticulum. Thus, 8 of 19 low-grade mucinous neoplasms (42%) were associated with diverticula. Of the appendices with both low-grade mucinous neoplasms and diverticula, three contained dissecting acellular mucin within the appendiceal wall, four showed diverticular perforation, and one had pseudomyxoma peritonei associated with the ruptured diverticulum.A significant percentage (P < .001) of cases contained low-grade mucinous neoplasms and diverticula together. The case of coexistent low-grade mucinous neoplasm, diverticulum, and pseudomyxoma peritonei suggests that diverticula could play a role in the pathogenesis of pseudomyxoma peritonei. This could occur either by involvement of preexisting diverticula by the neoplasm or by distention of the appendiceal lumen by mucin, leading to increased intraluminal pressure and subsequent diverticulum formation at a weak area in the wall. Either mechanism might allow low-grade mucinous neoplasms to penetrate the appendiceal wall more easily. KEY WORDS

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Section: Discussionmentioning

confidence: 99%

The Coexistence of Low-Grade Mucinous Neoplasms of the Appendix and Appendiceal Diverticula: A Possible Role in the Pathogenesis of Pseudomyxoma Peritonei

et al. 2000

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“…(3) Benign MCs, the most common form, accounting for 63-84% of mucoceles. These exhibit mostly epithelial villous adenomatous changes with some degree of epithelial atypia, and are characterized by marked distention of the Appendiceal Mucoceles Dig Dis 1998; 16:183-186 185 lumen up to 6 cm [4][5][6]. Our patient belongs to this group.…”

Section: Discussionmentioning

confidence: 99%

“…They are distinguished from the previous group by their glandular stromal invasion and/or presence of epithelial cells in the peritoneal implants. The luminal distention is usually severe [4][5][6].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Management of Appendiceal Mucoceles

Soweid¹,

Clarkston

Andrus³

et al. 1998

Dig Dis

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Preoperative diagnosis of appendiceal mucoceles is rare. If untreated, one type of mucoceles may rupture producing a potentially fatal entity known as pseudomyxoma peritonei. The importance of diagnosing appendiceal mucoceles is highlighted through a case presentation of a woman who had an incidental finding of mucinous cystadenoma of the appendix during colonoscopic evaluation for occult gastrointestinal bleeding. A detailed review of the medical literature regarding appendiceal mucoceles is presented, with emphasis on the pathologic, clinical, radiologic, and evolving endoscopic features. Surgical options and prognosis are discussed.

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“…A good prognosis and slow progression of disease, though, is an indication of low-grade malignant tumors, instances of PMP with rapidly growing tumors with local and distant metastases were reported {Limber et al., 1973;Bernhardt and Young, 1965). Another rare example of a rapidly growing adenocarcinoma of lung with thoracic pseudomyxoma was also reported (Guillam and Zelman, 1973).…”

Section: Commentmentioning

confidence: 99%

“…It is merely the result of profuse intraperitoneal extravasation of mucoid secretion of any origin.' Undoubtedly ovarian tumors {Limber Shanks, 1961;Little et al, 1969;Bernhardt and Young, 1965) and appendicular diseases {Limber et a l, 1973;Bernhardt and Young, 1965;Gibbs, 1973;Higa et al, 1973) are the leading causes of PMP, and rarely others {Jones, 1965). To our knowledge there is no case report of PMP resulting from gastric carcinoma in the literature.…”

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confidence: 99%