Appendiceal Mucocele in an Elderly Patient: How Much Surgery
Appendiceal mucoceles are rare cystic lesions with an incidence of 0.3–0.7% of all appendectomies. They are divided into four subgroups according to their histology. Even though the symptoms may vary – depending on the level of complication – from right lower quadrant pain, signs of intussusception,...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2011-09-01
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| Series: | Case Reports in Gastroenterology |
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| Online Access: | http://www.karger.com/Article/FullText/331438 |
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| author | C. Kim-Fuchs Y. Chittazhathu Kurian Kuruvilla E. Angst R. Weimann B. Gloor D. Candinas |
| author_facet | C. Kim-Fuchs Y. Chittazhathu Kurian Kuruvilla E. Angst R. Weimann B. Gloor D. Candinas |
| author_sort | C. Kim-Fuchs |
| collection | DOAJ |
| description | Appendiceal mucoceles are rare cystic lesions with an incidence of 0.3–0.7% of all appendectomies. They are divided into four subgroups according to their histology. Even though the symptoms may vary – depending on the level of complication – from right lower quadrant pain, signs of intussusception, gastrointestinal bleeding to an acute abdomen with sepsis, most mucoceles are asymptomatic and found incidentally. We present the case of a 70-year-old patient with an incidentally found appendiceal mucocele. He was seen at the hospital for backache. The CT scan showed a vertebral fracture and a 7-cm appendiceal mass. A preoperative colonoscopy displayed several synchronous adenomas in the transverse and left colon with high-grade dysplasia. In order to lower the cancer risk of this patient, we performed a subtotal colectomy. The appendiceal mass showed no histopathological evidence of malignancy and no sign of perforation. The follow-up was therefore limited to 2 months. In this case, appendectomy would have been sufficient to treat the mucocele alone. The synchronous high-grade dysplastic adenomas were detected in the preoperative colonoscopy and determined the therapeutic approach. Generally, in the presence of positive lymph nodes, a right colectomy is the treatment of choice. In the histological presence of mucinous peritoneal carcinomatosis, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy is indicated. In conclusion, mucoceles of the appendix are detected with high sensitivity by CT scan. If there is no evidence of synchronous tumor preoperatively and no peritoneal spillage, invasion or positive sentinel lymph nodes during surgery, a mucocele is adequately treated by appendectomy. |
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| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1662-0631 |
| language | English |
| last_indexed | 2024-12-23T02:08:03Z |
| publishDate | 2011-09-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Gastroenterology |
| spelling | doaj.art-cb6b3fc5340c43f198f8d8d9faa35afa2022-12-21T18:03:50ZengKarger PublishersCase Reports in Gastroenterology1662-06312011-09-015351652210.1159/000331438331438Appendiceal Mucocele in an Elderly Patient: How Much SurgeryC. Kim-FuchsY. Chittazhathu Kurian KuruvillaE. AngstR. WeimannB. GloorD. CandinasAppendiceal mucoceles are rare cystic lesions with an incidence of 0.3–0.7% of all appendectomies. They are divided into four subgroups according to their histology. Even though the symptoms may vary – depending on the level of complication – from right lower quadrant pain, signs of intussusception, gastrointestinal bleeding to an acute abdomen with sepsis, most mucoceles are asymptomatic and found incidentally. We present the case of a 70-year-old patient with an incidentally found appendiceal mucocele. He was seen at the hospital for backache. The CT scan showed a vertebral fracture and a 7-cm appendiceal mass. A preoperative colonoscopy displayed several synchronous adenomas in the transverse and left colon with high-grade dysplasia. In order to lower the cancer risk of this patient, we performed a subtotal colectomy. The appendiceal mass showed no histopathological evidence of malignancy and no sign of perforation. The follow-up was therefore limited to 2 months. In this case, appendectomy would have been sufficient to treat the mucocele alone. The synchronous high-grade dysplastic adenomas were detected in the preoperative colonoscopy and determined the therapeutic approach. Generally, in the presence of positive lymph nodes, a right colectomy is the treatment of choice. In the histological presence of mucinous peritoneal carcinomatosis, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy is indicated. In conclusion, mucoceles of the appendix are detected with high sensitivity by CT scan. If there is no evidence of synchronous tumor preoperatively and no peritoneal spillage, invasion or positive sentinel lymph nodes during surgery, a mucocele is adequately treated by appendectomy.http://www.karger.com/Article/FullText/331438MucoceleAppendixSynchronous tumorMucinous cystadenocarcinoma |
| spellingShingle | C. Kim-Fuchs Y. Chittazhathu Kurian Kuruvilla E. Angst R. Weimann B. Gloor D. Candinas Appendiceal Mucocele in an Elderly Patient: How Much Surgery Case Reports in Gastroenterology Mucocele Appendix Synchronous tumor Mucinous cystadenocarcinoma |
| title | Appendiceal Mucocele in an Elderly Patient: How Much Surgery |
| title_full | Appendiceal Mucocele in an Elderly Patient: How Much Surgery |
| title_fullStr | Appendiceal Mucocele in an Elderly Patient: How Much Surgery |
| title_full_unstemmed | Appendiceal Mucocele in an Elderly Patient: How Much Surgery |
| title_short | Appendiceal Mucocele in an Elderly Patient: How Much Surgery |
| title_sort | appendiceal mucocele in an elderly patient how much surgery |
| topic | Mucocele Appendix Synchronous tumor Mucinous cystadenocarcinoma |
| url | http://www.karger.com/Article/FullText/331438 |
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