Giant mucocele of appendix as pelvic mass: A rare presentation

Abstract

50-year-female presented to us with awareness of lump in right iliac fossa (RIF) for 3 months, gradually increasing in size with dull aching pain. On examination there was a lump in the RIF region arising from pelvis, it was 12 × 6 cm in On investigations routiene test were with in normal limits CA 125 level was 8.12 U/ml. Patient underwent radiological imaging and USG and CT were suggestive of adnexal mass (Fig. 1) , on laparotomy 13 × 6 cm cystic mass found replacing the appendix, both the adnexa were normal (Fig. 2). Histology was suggestive of benign mucocele of appendix. DiscussionMucocele of the appendix is a relatively uncommon pathology with a reported incidence of 0.2-0.3% in all appendectomy specimens [1].Two major pathological mechanisms are thought to be responsible for the formation of apendiceal mucocele; -plasia, or appendiceal lesions (e.g., fecaliths, endometriosis, diverticulae, polyps) and second tumors of the appendix (i.e., carcinoid, cystadenoma, cystadenocarcinoma). IMAGES IN SURGERY

Laparoscopic Appendectomy for Giant Appendiceal Mucocele in an Elderly Patient: A Case Report

“…Some authors prefer laparoscopic surgical procedures due to paced technological advancements, better viewing angles and the benefits of minimally-invasive procedures (e.g., advantages such as early mobilization, day treatment and reduced pain). But some authors are avoiding the laparoscopic surgical procedures because they can increase the rupture risk of the mucocele as well as the pseudomyxoma peritonei [7]. In the literature, publications are available showing that the laparoscopic treatment even for large-scale mucocele is successful and advantageous [8,9].…”

Appendiceal Mucocele: A Diagnosis To Keep in Mind When Encountering a Retrovesical Lesion

“…1 The most common symptoms include abdominal pain, changes in bowel habits, and weight loss. 3 Diagnosis is performed by imaging studies showing an encapsulated cystic lesion with calcifications (seen in 50% of cases), or by colonoscopy showing a pathognomonic erythematous soft mass with central crater and mucus discharge. 3 Treatment for a mucocele of the appendix includes conventional appendectomy and/or a right hemicolectomy (if bowel invasion occurs), which avoids iatrogenic rupture and pseudomyxoma peritonei.…”

“…3 Diagnosis is performed by imaging studies showing an encapsulated cystic lesion with calcifications (seen in 50% of cases), or by colonoscopy showing a pathognomonic erythematous soft mass with central crater and mucus discharge. 3 Treatment for a mucocele of the appendix includes conventional appendectomy and/or a right hemicolectomy (if bowel invasion occurs), which avoids iatrogenic rupture and pseudomyxoma peritonei. This case shows the importance of including an appendiceal mucocele in the broad differential diagnosis of a calcified retrovesical mass.…”