Mucocele of the appendix: ultrasonographic and CT findings

Kim, S. H.; Lim, Hyo Keun; Lee, Won Jae; Lim, Jihyun; Byun, Jae Young

doi:10.1007/s002619900343

Cited by 122 publications

(127 citation statements)

References 6 publications

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“…8 Dachman et al 13 and Zissin et al 14 tial diagnosis of benign mucocele. As to our patient, in retrospect, the small area of enhancement at CT suggesting a solid component 3,7,14 and the spontaneous rupture of the mass 8 at the time of laparotomy should have raised the suspicion of malignancy. In these cases, either an understaging of the disease or a true progression toward malignancy 14 must be considered.…”

Section: Discussionmentioning

confidence: 99%

“…19 Although most pathologic entities at the origin of a mucocele are benign, malignant potential should not be forgotten: 12% to 36% of mucoceles, in fact, are caused adenocarcinoma. 1,7,8 In addition, benign mucoceles are associated with synchronous tumors elsewhere (notably colonic and ovarian cancer) in as many as 30% of patients. 1,8,16 The development of malignant pseudomyxoma peritonei in one of our patients stresses the complexity of the clinicopathologic appearance and evolution of this disease.…”

Section: Discussionmentioning

confidence: 99%

“…8 Computed tomography has been claimed to be the most informative imaging technique for the preoperative diagnosis of mucocele. 7,14,17 A hypoattenuating cysticlike mass arising from the appendiceal region, sometimes with curvilinear mural calcifications, irregular thickening of the wall, or both, is considered the most specific CT feature of mucocele. 3,7,14 However, most CT findings are insensitive; thin walls and mural calcifications are seen in half the cases.…”

Section: Discussionmentioning

confidence: 99%

“…6,7,[11][12][13][14][15][16] A correct preoperative diagnosis has been reported in only a minority of cases. 17 In the most recent and widest surgical series, 8 only 20% of 129 patients with pathologically proved mucoceles had a correct preoperative diagnosis.…”

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Giant Mucocele of the Appendix

Francica

Lapiccirella

Giardiello

et al. 2006

Journal of Ultrasound in Medicine

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Objective. Clinical and imaging (sonographic and computed tomographic [CT]) findings in 3 cases of giant mucocele of the appendix are described. Methods. Clinical records of 3 cases of giant mucocele of the appendix were reviewed. All patients had a basal B-mode sonographic examination and a contrast-enhanced sonographic examination using a second-generation low-mechanical index contrast medium. In all cases, a dual-phase spiral CT examination was carried out. Results. In 2 cases, the abdominal masses were discovered in asymptomatic patients; 1 patient had vague abdominal discomfort. A pathologic diagnosis of benign cystoadenoma was found at pathologic examination in all cases, and malignant pseudomyxoma peritonei was disclosed in 1 patient 1 year later. Common sonographic findings were as follows: (1) a huge abdominal mass with a maximum diameter ranging between 20 and 25 cm; (2) a thin hyperechoic border without either solid vegetations or signs of infiltration of surrounding tissues; (3) a complex internal echo structure with anechoic lacunae interspersed between curvilinear, wavy bands of echogenic material (the so-called sonographic onion skin sign); and (4) avascularity of the masses shown on contrast-enhanced sonography with a low-mechanical index medium. At CT, a well-circumscribed cysticlike mass of low attenuation was displayed in all cases. There was lack of enhancement during a dual-phase examination in 2 cases; in the other, a small peripheral area of faint enhancement was appreciated. Only in the latter case could CT reliably assess the origin of the mass. Conclusions. It is suggested that a combination of sonographic (namely the onion skin sign) and CT findings may aid in the correct preoperative diagnosis of giant mucocele of the appendix.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Giant Mucocele of the Appendix

Francica

Lapiccirella

Giardiello

et al. 2006

Journal of Ultrasound in Medicine

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“…CT of the abdomen usually shows a cystic wellin the expected location of the appendix [4]. Ultrasound…”

Section: Images In Surgerymentioning

confidence: 99%

Giant mucocele of appendix as pelvic mass: A rare presentation

Goyal

Bagree

et al. 2010

Indian J Surg

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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

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Surgical Treatment of Appendiceal Mucocele

Stocchi¹

2003

Arch Surg

172

161

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All cases of primary appendiceal mucoceles (simple mucocele, cystadenoma, cystadenocarcinoma) diagnosed between 1976 and 2000 were reviewed. There were 135 patients, 74 of whom were female. Mean age at diagnosis was 59 years. Mean follow-up was more than 6 years.Interventions: A total of 129 patients underwent surgery, consisting of appendectomy (22 patients), right hemicolectomy (25 patients), or more extensive procedures (82 patients).Main Outcome Measures: Clinical, diagnostic, and surgical variables were statistically compared with post-operative morbidity and mortality and the presence of malignancy. PϽ.05 was considered significant.Results: The presence of symptoms was associated with malignancy (58% vs 15%, PϽ.001), particularly abdominal pain (56% vs 29%, P=.005) and weight loss (77% vs 31%, P=.002). Abdominal mass was also associated with malignancy (86% vs 25%, PϽ.001). Moreover, pseudomyxoma peritonei and mucocele extravasation were associated with malignancy (95% vs 13%, PϽ.001, and 83% vs 15%, PϽ.001, respectively). The lesion size was not associated with malignancy; however, cystadenomas were significantly larger than simple mucoceles (8.1 cm vs 4.1 cm, PϽ.001), and no cystadenoma was less than 2 cm in largest diameter.Conclusions: A number of clinical, diagnostic, and intraoperative findings are associated with malignant mucoceles. All mucoceles greater than 2 cm should be excised to remove premalignant lesions.

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Mucocele of the appendix: ultrasonographic and CT findings

Abstract: US and CT were useful methods in diagnosing mucocele of the appendix and differentiating this condition from mimicking diseases. Nodular enhancing lesion in the wall of the mucocele may be a finding suggestive of malignant cause of mucocele.

Cited by 122 publications

References 6 publications

Giant Mucocele of the Appendix

Giant Mucocele of the Appendix

Giant mucocele of appendix as pelvic mass: A rare presentation

Surgical Treatment of Appendiceal Mucocele

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