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Appendiceal Mucocele. A retrospective Analysis of 19 Cases

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Abstract

Background

Appendiceal mucocele is an infrequent well-recognized entity that can present in a variety of clinical syndromes or can be asymptomatic and discovered incidentally.

Patients and Methods

Nineteen patients with a diagnosis of primary appendiceal mucocele treated in our institution between January 1, 1987 and December 31, 2006 were included in this retrospective analysis.

Results

The histological examination of the specimens revealed simple and hyperplastic appendiceal mucocele in nine cases (47%), mucinous appendiceal cystadenoma in eight cases (42%), and mucinous appendiceal cystadenocarcinoma in two cases (11%). Thirteen patients (68%) underwent appendectomy, five patients (26%) right colectomy, and two patients (6%) underwent right colectomy for invasive appendiceal cystadenocarcinoma and at the same time right nephrectomy and sigmoidectomy, respectively, for concomitant malignancy.

Conclusion

Mucocele of the appendix may be related to a benign or malignant appendiceal process, leading to individualized diagnosis and treatment.

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References

  1. Aho AJ, Heinonen R, Lauren P. Benign and malignant mucocele of the appendix: histological type and prognosis. Acta Chir Scand. 1973;139:392–400.

    PubMed  CAS  Google Scholar 

  2. Pai R, Longacre T. Appendiceal mucinous tumors and pseudomyxoma peritonei. Adv Anat Pathol. 2005;12(6):291–311. doi:10.1097/01.pap.0000194625.05137.51.

    Article  PubMed  Google Scholar 

  3. Crawford J. Tumors of the appendix. In: Cotran R, Kumar V, Robbins S, editors. Pathologic basis of disease. Philadelphia: Saunders; 1994. p. 824–25.

    Google Scholar 

  4. Landen S, Bertrand C, Maddern GJ, Herman D, Pourbaix A, de Neve A, et al. Appendiceal mucoceles and pseudomyxoma peritonei. Sur Gynecol Obstet. 1992;175:401–4.

    CAS  Google Scholar 

  5. 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;32:1525–41. doi:10.1002/1097-0142(197312)32:6<1525::AID-CNCR2820320632>3.0.CO;2-C.

    Article  PubMed  CAS  Google Scholar 

  6. Mills SE, et al. Sternberg’s diagnostic surgical pathology (Alimentary canal and associated organs). 4th ed. Ambler: Lippincott Williams and Wilkins; 2004. p. 1576–99.

    Google Scholar 

  7. Gibbs NM. Mucinous cystadenoma and cystadenocarcinoma of the vermiform appendix with particular reference to mucocele and pseudomyxoma peritonei. J Clin Pathol. 1973;26:413–21. doi:10.1136/jcp.26.6.413.

    Article  PubMed  CAS  Google Scholar 

  8. Kabbani W, Houlihan PS, Luthra R, Hamilton SR, Rashid A. Mucinous and non-mucinous appendiceal adenocarcinomas: different clinicopathological features but similar genetic alterations. Mod Pathol. 2002;15:599–605. doi:10.1038/modpathol.3880572.

    Article  PubMed  Google Scholar 

  9. Sugarbaker PH. The natural history, gross pathology and histopathology of appendiceal epithelial neoplasms. EJSO 2006;32:644–47. doi:10.1016/j.ejso.2006.03.016.

    Article  PubMed  CAS  Google Scholar 

  10. van Ruth S, Acherman YIZ, van der Vijvert MJ, Hart AAM, Verwaal VJ, Zoetmulder FAN. Pseudomyxoma peritonei: a review of 62 cases. EJSO 2003;29:682–8. doi:10.1016/S0748-7983(03)00149-5.

    Article  PubMed  Google Scholar 

  11. Makris I, Lazaridis Ch, Efthimiou M, Kalaitzis E, Chatzi M, Papanicolaou A, et al. Mucocele of the appendix and pseudomyxoma peritonei. Galenus 1995;37:673–8.

    Google Scholar 

  12. Carr NJ, McCarthy WF, Sobin LH. Epithelial noncarcinoid tumors and tumor-like lesions of the appendix: a clinicopathologic study of 184 patients with a multivariate analysis of prognostic factors. Cancer 1995;75:757–68. doi:10.1002/1097-0142(19950201)75:3<757::AID-CNCR2820750303>3.0.CO;2-F.

    Article  PubMed  CAS  Google Scholar 

  13. Connor SJ, Hanna GB, Frizelle FA. Appendiceal tumors: retrospective clinicopathologic analysis of appendiceal tumors from 7,970 appendectomies. Dis Colon Rectum. 1998;41:75–80. doi:10.1007/BF02236899.

    Article  PubMed  CAS  Google Scholar 

  14. Rampone B, Roviello F, Marrelli D, Pinto E. Giant appendiceal mucocele: report of a case and brief review. World J Gastroenterol. 2005;11(30):4761–3.

    PubMed  Google Scholar 

  15. Peek DF, Beets GL. Pseudomyxoma peritonei in the pleural cavity: report of a case. Dis Colon Rectum. 1999;42:113–6. doi:10.1007/BF02235194.

    Article  PubMed  CAS  Google Scholar 

  16. Takahashi S, Furukawa T, Ueda J. Case report: mucocele of the tip of the appendix. Clin Radiol. 1998;53:149–50. doi:10.1016/S0009-9260(98)80064-0.

    Article  PubMed  CAS  Google Scholar 

  17. Stevens KJ, Dunn K, Balfour T. Pseudomyxoma extraperitonei: a lethal complication of mucinous adenocarcinoma of the appendix. Am J Gastroenterol. 1997;92:1920–2.

    PubMed  CAS  Google Scholar 

  18. Dachman AH, Lichtenstein JE, Friedman AC. Mucocele of the appendix and pseudomyxoma peritonei. Am J Roentgenol. 1985;144:923–9.

    CAS  Google Scholar 

  19. Soweid AM, Clarkston WK, Andrus CH, Janney CG. Diagnosis and management of appendiceal mucoceles. Dig Dis. 1998;16:183–6. doi:10.1159/000016863.

    Article  PubMed  CAS  Google Scholar 

  20. Roberge RJ, Park AJ. Mucocele of the appendix: an important clinical parity. J Emer Med. 2006;30(3):303–6. doi:10.1016/j.jemermed.2005.05.026.

    Article  Google Scholar 

  21. Pickhardt PJ, Levy AD, Rohrmann CA Jr, Kende AE. Primary neoplasms of the appendix manifesting as acute appendicitis: CT findings with pathologic comparison. Radiology 2002;224:775. doi:10.1148/radiol.2243011545.

    Article  PubMed  Google Scholar 

  22. Kim SH, Lim HK, Lee WJ, Lim JH, Byun JY. Mucocele of the appendix: ultrasonographic and CT findings. Abdom Imaging. 1998;23:292–6. doi:10.1007/s002619900343.

    Article  PubMed  CAS  Google Scholar 

  23. Zissin R, Gayer G, Kotos E, Apter S, Peri M, Sharipo-Feinberg M. Imaging of mucocele of the appendix with emphasis on the CT findings: a report of 10 cases. Clin Radiol. 1999;54:826–32. doi:10.1016/S0009-9260(99)90687-6.

    Article  PubMed  CAS  Google Scholar 

  24. Isaacs KL, Warshauer DM. Mucocele of the appendix: computer tomographic, endoscopic and pathologic correlation. Am J Gastroenterol. 1992;87:787–9.

    PubMed  CAS  Google Scholar 

  25. Hamilton DL, Stormont JM. The volcano sign of appendiceal mucocele. Gastrointest Endosc. 1989;35:453–6.

    Article  PubMed  CAS  Google Scholar 

  26. Miraliakbari R, Chapman WH III. Laparoscopic treatment of an appendiceal mucocele. J Laparoendoscop Adv Surg Tech A. 1999;9:159–63.

    CAS  Google Scholar 

  27. Gonzales-Moreno S, Shmookler BM, Sugarbaker PH. Appendiceal mucocele. Contraindication to laparoscopic appendectomy. Surg Endosc 1998;12:1177–9. doi:10.1007/s004649900811.

    Article  Google Scholar 

  28. Ruiz-Tovar J, Teruel DG, Castineiras VM, Dehesa AS, Quindos PL, Molina EM. Mucocele of the appendix. World J Surg. 2007;31:542–8. doi:10.1007/s00268-006-0454-1.

    Article  PubMed  CAS  Google Scholar 

  29. Gonzalez-Moreno S, Sugarbaker PH. Right hemicolectomy does not confer a survival advantage in patients with mucinous carcinoma of the appendix and peritoneal seeding. Br J Surg. 2004;91:304–11. doi:10.1002/bjs.4393.

    Article  PubMed  CAS  Google Scholar 

  30. McGory ML, Maggard MA, Kang H, O’ Connel JB, Ko CY. Malignancies of the appendix: beyond case series reports. Dis Colon Rectum 2005;48:2264–71. doi:10.1007/s10350-005-0196-4.

    Article  PubMed  Google Scholar 

  31. Stocchi L, Wolff B, Larson D, Harrington J. Surgical treatment of appendiceal mucocele. Arch Surg. 2003;138:585–90. doi:10.1001/archsurg.138.6.585.

    Article  PubMed  Google Scholar 

  32. Wolff M, Ahmed N. Epithelial neoplasms of the vermiform appendix (exclusive of carcinoid): adenocarcinomas of the appendix. Cancer 1976;37:2493–510. doi:10.1002/1097-0142(197605)37:5<2493::AID-CNCR2820370543>3.0.CO;2-D.

    Article  PubMed  CAS  Google Scholar 

  33. Dhage-Ivatury S, Sugarbaker PH. Update on the surgical approach to mucocele of the appendix. J Am Coll Surg. 2006;202:680–4. doi:10.1016/j.jamcollsurg.2005.12.003.

    Article  PubMed  Google Scholar 

  34. Sugarbaker PH, Ronnett BM, Archer A, et al. Pseudomyxoma peritonei. Adv Surg. 1997;31:233–80.

    Google Scholar 

  35. Misdraji J. Epithelial neoplasms and other epithelial lesions of the appendix (excluding carcinoid tumors). Curr Diagn Pathol. 2005;11:60–71. doi:10.1016/j.cdip.2004.10.003.

    Article  Google Scholar 

  36. Solkar MH, Akhtar NM, Khan Z, Parker MC. Pseudomyxoma extraperitonei occurring 35 years after appendicectomy: a case report and review of the literature. World J Surg Oncol. 2004;2(1):19. doi:10.1186/1477-7819-2-19.

    Article  PubMed  Google Scholar 

  37. Smeenk RM, van Velthuysen MLF, Verwaal VJ, Zoetmulder FAN. Appendiceal neoplasms and pseudomyxoma peritonei: a population based study. EJSO 2008;34:196–201.

    PubMed  CAS  Google Scholar 

  38. Sugarbaker PH. New standard of care for appendiceal epithelial neoplasms and pseudomyxoma peritonei syndrome? Lancet Oncol. 2006;7:69–76. doi:10.1016/S1470-2045(05)70539-8.

    Article  PubMed  Google Scholar 

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Correspondence to B. Papaziogas.

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Papaziogas, B., Koutelidakis, I., Tsiaousis, P. et al. Appendiceal Mucocele. A retrospective Analysis of 19 Cases. J Gastrointest Canc 38, 141–147 (2007). https://doi.org/10.1007/s12029-008-9030-2

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