Intussusception of the appendix secondary to mucinous cystadenoma.

Intussusception of the appendix vermiformis in adults is an unusual entity. We present a 52-year-old male patient with intussusception of the appendix due to a mucinous cystadenoma, and discuss the clinical features, preoperative diagnosis, classification and therapy of this condition together with a review of the literature.     

Laparoscopic reduction of appendicocecal intussusception due to mucinous cystadenoma in an adult.

OBJECTIVE: Laparoscopic reduction of appendicocecal intussusception due to mucinous cystadenoma is herein described. METHODS: A 32-year-old female had intermittent abdominal pain and nonbloody diarrhea. The preoperative diagnosis was intussusception of the colon with a benign tumor by CT-scan findings. RESULTS: Laparoscopic reduction of intussusception and ileocecal resection were successfully performed. Gauze sponge sticks were used to provide compression from the distal colon. This maneuver was very effective to reduce the intussusception. CONCLUSION: Laparoscopic reduction of intussusception due to a benign tumor is feasible and safe even in adults. Mucinous cystadenoma is one of the causes of intussusception in adults and a good indication for the laparoscopic approach.     

Giant mucinous cystadenoma of the appendix

Mucocele of the appendix is a rare entity, characterized by distension of the lumen caused by an accumulation of mucoid substance. We report herein the case of a 73-year-old man with a 3-week history of abdominal pain caused by a large mucinous cystadenoma. The lesion was removed intact, which is the optimal treatment.     

Intussusception of the appendix secondary to mucinous cystadenoma: A rare cause of abdominal pain

A 35-year-old woman was seen as an outpatient with a 3-month history of pain in the right iliac fossa. A CT scan of her abdomen revealed the presence of a mucocele of the appendix. Intra-operatively, an appendico-appendicular intussusception was found. Histology confirmed the presence of a mucinous cystadenoma with the presence of acellular mucin on the serosal surface of the appendix. This association has rarely been described in the literature. Prompt surgical intervention is advocated to prevent the subsequent development of pseudomyxoma peritonei. We present a case of intussusception of the appendix with a mucinous cystadenoma as its lead point.     

阑尾黏液性囊腺瘤并发成人回盲肠套叠一例

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Asymptomatic intussusception of the appendix secondary to endometriosis

This is a report of a 47-year-old woman with an asymptomatic clinical presentation of appendiceal intussusception secondary to endometriosis. Initially discovered during routine colonoscopy as a submucosal mass, it was ultimately diagnosed after surgical resection by pathology findings. The theories regarding the pathogenesis of appendiceal intussusception are reviewed and discussed here.     

Pseudomyxoma peritonei associated with mucinous cystadenoma of the appendix

The authors report a case of a male 86 years old patient with peritoneal pseudomyxoma associated to cystoadenoma of the appendix. Preoperative CT scan showed the presence of a mass in the appendiceal site containing a gelatinous fluid collection and calcifications. Notwithstanding, diagnosis of pseudomyxoma was preoperatively considered less probable due to the rarity of the affection and the advanced age. At laparatomy was revealed the presence of the large mass observed at CT scan, involving the caecum and occupying the retroperitoneal space along the ascending colon. Mucinous ascites was present without invasive mucinous implants in the peritoneum. Operation consisted in a right hemicolectomy with total removal of the retroperitoneal mass and evacuation of the mucinous ascites. Histology confirmed the clinical diagnosis of pseudomyxoma peritonei associated to cystoadenoma of the appendix. The case is of paradigmatic interest as being quite correspondent to the classical Ronnett's definition of pseudomyxoma: a clinicopathological entity characterized by mucinous ascites and non-invasive mucinous implants with a characteristic distribution and containing histologically benign mucinous epithelium derived from an appendiceal mucinous adenoma and having a benign course. According to such definition, the authors stress the importance of an appropriate classification of the observed cases of pseudomyxoma, under whose term is often collected a heterogeneous group of pathological lesions, in order to better evaluate the prognosis and treatment.     

Laparoscopic resection of mucinous cystadenoma of appendix: a careful decision

Appendiceal mucoceles are mainly due to cystadenoma or cystadenocarcinoma. Definite diagnosis is difficult preoperatively and is usually peroperatively. Surgical excision, either by laparoscopy or by laparotomy, is the mainstay of treatment. Rupture of the lesion causes pseudomyxoma peritonei. We present a case to highlight this point and especially deplore the use of laparoscopy if the tumor clearly extends beyond the appendix.     

Enterovesical fistula secondary to mucinous adenocarcinoma of appendix

We report an unusual case of an enterovesical fistula secondary to adenocarcinoma of the appendix.     

Intussusception of the appendix by mucinous cystadenoma. Report of a case with an unusual clinical presentation

Appendiceal mucocele is a very rare clinical condition. Associated ascites and an ovarian mass could suggest synchronous ovarian cystadenocarcinoma with pseudomyxoma peritonei. We describe the case of a 36-year-old female with a mucinous cystadenoma of the appendix causing intussusception, diagnosed by CT but not by US scan, since the associated anomalous fixation of the caecum was misleading in defining the precise anatomical site. Although the CT findings were accurate, the synchronous presence of an ovarian cyst and ascites did not allow us to rule out preoperatively a concurrent cystadenocarcinoma of the ovary with pseudomyxoma peritonei. The appropriate surgical treatment was performed on the basis of intraoperative frozen section examination. Surgical treatment depends on the nature of the mucocele: retention forms are effectively treated by appendectomy, while neoplastic conditions require a more extended resection. Treatment of associated ovarian cystadenocarcinoma and pseudomyxoma peritonei includes right colectomy, bilateral ovariectomy and omentectomy. Although a precise preoperative diagnosis of mucocele associated with intussusception of the appendix has been reported as possible, concomitant ascites and ovarian masses, as in the present case, could mimic pseudomyxoma peritonei from concurrent ovarian cystadenocarcinoma. Intraoperative histopathology is required in order to perform the most appropriate treatment.     

Mucinous cystadenoma of the appendix

Mucinous neoplasms of the Appendix are rare conditions, usually diagnosed intraoperatively or postoperatively on the pathology report. They have an association with colonic and ovarian neoplasms, and spillage can result in pseudomyxoma peritonei. While appendicectomy is adequate treatment for cystadenomas, cystadenocarcinomas require a right hemicolectomy. Open approach is recommended for the surgical treatment of these lesions.     

Chronic abdominal pain secondary to a mucous cystadenoma of the appendix in a 10-year-old boy

Mucocele of the appendix is a thin-walled dilated appendix filled with mucus. It occurs secondary to chronic obstruction of the appendiceal lumen because of a range of pathologies. Cystadenomas in children are exceedingly rare and most frequently of ovarian origin. A mucous cystadenoma of the appendix in a 10-year-old boy with chronic abdominal pain is presented.