Low-grade Appendiceal Mucinous Neoplasm: A Series of Four Cases
Low-grade Appendiceal Mucinous Neoplasm (LAMN) is a rare malignant neoplasm seen in less than 0.3% of appendectomy specimens. Patients with LAMN can present with abdominal pain, mimicking appendicitis clinically. In later stages, it can rupture, leading to Pseudomyxoma peritonei (PMP). Therefore,...
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JCDR Research and Publications Private Limited
2023-07-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/18232/63453_CE[Ra1]_F(SHU)_PF1(AN_IS)_PF2(AG_KM)_PFA(AG_KM)_PN(KM).pdf |
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| author | Chandan Chowdhuri Ashwinkumar K Barsagade Sivaganesh Alias Porko Avnika jasuja Suparna Dubey |
| author_facet | Chandan Chowdhuri Ashwinkumar K Barsagade Sivaganesh Alias Porko Avnika jasuja Suparna Dubey |
| author_sort | Chandan Chowdhuri |
| collection | DOAJ |
| description | Low-grade Appendiceal Mucinous Neoplasm (LAMN) is a rare malignant neoplasm seen in less than 0.3% of appendectomy
specimens. Patients with LAMN can present with abdominal pain, mimicking appendicitis clinically. In later stages, it can rupture,
leading to Pseudomyxoma peritonei (PMP). Therefore, a high clinical suspicion is needed for correct diagnosis and management.
The prognosis of LAMN depends on the presence or absence of mucin/neoplastic epithelium outside the appendix. For LAMN
confined to the appendix, appendectomy alone is sufficient for management, with conservative follow-up. For LAMN with extruded
acellular mucin localised to the appendiceal serosa, management involves appendectomy and PMP surveillance. For all mucinous
lesions of the appendix, it is essential to submit the entire appendix for histopathologic examination, thoroughly evaluating the
presence of mucin/neoplastic epithelium involving the serosa/extra appendiceal tissue for accurate staging and to predict the risk
of recurrence and determine further management. Here four cases of LAMN due to their rarity and clinical importance is presented.
This study of four cases emphasises that the clinical diagnosis of this rare malignancy is difficult, and radiological investigations
were not available as these patients presented with clinical features mimicking appendicitis. Emergency appendectomy was
performed in all cases. LAMN should be considered as a differential diagnosis because if not diagnosed and treated in the early
stages, it can lead to dreaded complications like PMP. The histopathological examination of all four cases of LAMN showed
dissecting acellular mucin in various stages of progression in the appendicular wall, but none involving the serosa. This highlights
the importance of timely surgical intervention and histopathological examination for an exact diagnosis and staging of LAMN for
further follow-up or treatment. |
| first_indexed | 2024-03-12T17:01:43Z |
| format | Article |
| id | doaj.art-4ee1db48bb5c44e9a2aa149a7f5029b4 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-03-12T17:01:43Z |
| publishDate | 2023-07-01 |
| publisher | JCDR Research and Publications Private Limited |
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| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-4ee1db48bb5c44e9a2aa149a7f5029b42023-08-07T11:59:18ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2023-07-01177061010.7860/JCDR/2023/63453.18232Low-grade Appendiceal Mucinous Neoplasm: A Series of Four CasesChandan Chowdhuri0Ashwinkumar K Barsagade1Sivaganesh Alias Porko2Avnika jasuja3Suparna Dubey4Assistant Professor, Department of Pathology, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar, India.Associate Professor, Department of Pathology, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar, India.Associate Professor, Department of Pathology, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar, India.Assistant Professor, Department of Pathology, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar, India.Professor and Head, Department of Pathology, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar, India.Low-grade Appendiceal Mucinous Neoplasm (LAMN) is a rare malignant neoplasm seen in less than 0.3% of appendectomy specimens. Patients with LAMN can present with abdominal pain, mimicking appendicitis clinically. In later stages, it can rupture, leading to Pseudomyxoma peritonei (PMP). Therefore, a high clinical suspicion is needed for correct diagnosis and management. The prognosis of LAMN depends on the presence or absence of mucin/neoplastic epithelium outside the appendix. For LAMN confined to the appendix, appendectomy alone is sufficient for management, with conservative follow-up. For LAMN with extruded acellular mucin localised to the appendiceal serosa, management involves appendectomy and PMP surveillance. For all mucinous lesions of the appendix, it is essential to submit the entire appendix for histopathologic examination, thoroughly evaluating the presence of mucin/neoplastic epithelium involving the serosa/extra appendiceal tissue for accurate staging and to predict the risk of recurrence and determine further management. Here four cases of LAMN due to their rarity and clinical importance is presented. This study of four cases emphasises that the clinical diagnosis of this rare malignancy is difficult, and radiological investigations were not available as these patients presented with clinical features mimicking appendicitis. Emergency appendectomy was performed in all cases. LAMN should be considered as a differential diagnosis because if not diagnosed and treated in the early stages, it can lead to dreaded complications like PMP. The histopathological examination of all four cases of LAMN showed dissecting acellular mucin in various stages of progression in the appendicular wall, but none involving the serosa. This highlights the importance of timely surgical intervention and histopathological examination for an exact diagnosis and staging of LAMN for further follow-up or treatment.https://jcdr.net/articles/PDF/18232/63453_CE[Ra1]_F(SHU)_PF1(AN_IS)_PF2(AG_KM)_PFA(AG_KM)_PN(KM).pdfappendicectomymucinpseudomyxoma peritonei |
| spellingShingle | Chandan Chowdhuri Ashwinkumar K Barsagade Sivaganesh Alias Porko Avnika jasuja Suparna Dubey Low-grade Appendiceal Mucinous Neoplasm: A Series of Four Cases Journal of Clinical and Diagnostic Research appendicectomy mucin pseudomyxoma peritonei |
| title | Low-grade Appendiceal Mucinous Neoplasm: A Series of Four Cases |
| title_full | Low-grade Appendiceal Mucinous Neoplasm: A Series of Four Cases |
| title_fullStr | Low-grade Appendiceal Mucinous Neoplasm: A Series of Four Cases |
| title_full_unstemmed | Low-grade Appendiceal Mucinous Neoplasm: A Series of Four Cases |
| title_short | Low-grade Appendiceal Mucinous Neoplasm: A Series of Four Cases |
| title_sort | low grade appendiceal mucinous neoplasm a series of four cases |
| topic | appendicectomy mucin pseudomyxoma peritonei |
| url | https://jcdr.net/articles/PDF/18232/63453_CE[Ra1]_F(SHU)_PF1(AN_IS)_PF2(AG_KM)_PFA(AG_KM)_PN(KM).pdf |
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