CASE REPORTS   

Chirurgia 2014 February;27(1):61-3

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: English

Case report on a pelvic mass: giant appendiceal mucocele

Dioscoridi L., Duranti E., Freschi G.

Second Unit of General and Emergency Surgery, Chief Prof. Paolo Bechi, Careggi Hospital, Florence, Italy

Appendiceal mucocele is a rare disease (0.3% of all appendicopathies) and is characterized by the accumulation of mucoid material in the appendiceal lumen. Its ethiopathogenesis can be either inflammatory or neoplastic. Four entities can be distinguished on the basis of histopathologic epithelial characteristics: simple appendiceal mucocele, mucocele with epithelial hyperplasia, cystadenoma and cystadenocarcinoma; the last two subgroups represent neoplastic forms. Clinically it can remain either asymptomatic for long time or it can manifest with abdominal pain that can be associated with the presence of a palpable mass. The most common clinical manifestation is pain in the right iliac fossa, therefore it mimicks acute appendicitis. Correct diagnosis before surgery is very important for the selection of adequate surgical treatment in order to avoid intraoperative and postoperative complications. The authors present a case report of a 62-year-old patient who came to our attention for a pelvic swelling occasionally discovered during abdominal U.S. performed for screening of prostate cancer. The subsequent abdominal CT with contrast medium showed a polyciclyc mass with the calcification of the wall. Open surgery was performed and a cystic mass of the appendix was discovered in the right iliac fossa, in contact with the last loop of the small bowel, the posterior peritoneum of the pelvis, the Douglas pouch and the rectum. The histopathological examination confirmed the diagnosis of appendicular mucocele.