Sierra-Montenegro E, Sierra-Luzuriaga G, Leone-Stay G, Quiñonez-Auria C, Salazar-Menéndez V

Language: Spanish
References: 12
Page: 257-260
PDF size: 331.24 Kb.

ABSTRACT

Background: Pathology of the appendix represents >50% of surgical activity. It is necessary to consider rare pathologies such as mucoceles. These have a high frequency in females with a F/M ratio of 4:1, as well as in patients >50 years of age. The objective of this study is to report on a case of mucinous cystadenoma of the appendix.
Clinical case: We present the case of a 34-year-old male with a history of juvenile rheumatoid arthritis diagnosed at 9 years of age. At 22 years of age, the patient underwent bilateral hip arthroplasty. Since 1998, the patient has presented with renal amyloidosis and has been under steroid treatment to date. The current problem evolved 1 year ago during control studies for his disease. Computed tomography (CT) of the abdomen was done, demonstrating a tumor in the right iliac fossa. Colonoscopy confirmed a tumor with smooth edges located in the cecum. Surgery was recommended with a diagnosis of lipoma of the cecum. During surgery, a large tumor was found, indicating a poor prognosis. Right hemicolectomy was done. Surgical specimen was sent to pathology with a report of mucinous cystadenoma.
Conclusions: The group of symptoms of cystadenoma is nonspecific. Diagnostic methods include X-rays, ultrasound, CT and colonoscopy. Mucinous cystadenoma is the most common form of mucocele of the appendix. Diagnostic protocols are the same for benign appendix pathology. Treatment is surgical and type of surgery depends on the size of the mucocele. Mucoceles of the appendix are pathologies with a favorable prognosis when appropriate treatment is done.

REFERENCES

1. Aho AJ, Heinomen R, Lauren P. Benign and malignant mucocele of the appendix. Acta Chir Scand 1973;139:392-400.

2. Pastor FA, Gómez S, Ortuño G. Sobre el llamado mucocele apendicular versus cistoadenoma mucinoso. Rev Esp Enf Dig 1989;75:481-483.

3. Higa E, Rosai J, Pizzimbono CA, Wise L. Mucosal hyperplasia, mucinous cystadenoma and mucinous cystadenocarcinoma of the appendix: a re-evaluation of appendiceal “mucocele”. Cancer 1973;32:1525-1541.

4. Landen S, Bertrand C, Maddern GJ, Herman D, Poubaix A, de Neve A, et al. Appendical mucoceles and pseudomyxoma peritoneal. Surg Gynecol Obstet 1992;175:401-404.

5. Pureti M, Hollingworth J, Palaniappan M. Appendiceal mucocele misdiagnosed as an ovarian tumor. J Obstet Gynecol 2006;26:484-485

6. Stevens KJ, Dunn K, Balfour T. Pseudomyxoma extraperitonei: lethal complication of mucinous adenocarcinoma of the appendix. Am J Gastroenterol 1997;92:1920-1922.

7. Kim SH, Lim HK, Lee WJ, Lim HJ, Buyn JY. Mucocele of the appendix: ultrasonographic and CT findings. Abdom Imaging 1998;23:292- 296.

8. Echenique-Elizondo M, Liron C, Amondarain JA, Aribe X. Mucoceles apendiculares. Cir Esp 2007;82:297-300.

9. Soweid AM, Clarston WK, Andrus CH. Diagnosis and management of appendical mucoceles. Dig Dis 1998;16:183-186.

10. Gonzales Moreno S, Shmookler BM, Sugarbaker PH. Appendiceal mucocele. Contraindications to laparoscopic appendectomy. Surg Endsoc 1998;12:1177-1179.

11. Kahn M, Friedman IH. Mucocele of the appendix: diagnosis and surgical management. Dis Colon Rectum 1979;22:267-269.

12. Simon SM, Lee Y. Mucinous cystadenoma of the appendix. J Can Chir 2009;52:158-159.