Appendiceal mucocele masquerading as an epithelial borderline ovarian tumor: a case report and literature review

다국어 초록 (Multilingual Abstract)

Appendiceal mucocele is a rare mucin-producing neoplasm of appendiceal origin. Due to its location and imaging findings, appendiceal mucocele is easily confused with tumors of the right adnexa. We present a rare case of a patient initially misdiagnosed with an ovarian tumor intraoperatively diagnosed as an appendiceal mucocele and successfully treated. A 66-year-old postmenopausal woman was admitted to the gynecology department for an asymptomatic pelvic mass. Preoperative pelvic imaging showed an 8-cm cystic mass. Exploratory laparoscopy for the suspected epithelial borderline tumor from the right ovary revealed a cystic mass in the right pelvic area and normal uterus, fallopian tubes, and ovaries. Intraoperative consultation with the general surgery department confirmed the appendiceal origin. Laparoscopic appendectomy was performed. Histopathological examination confirmed a low-grade mucinous neoplasm of appendiceal origin. The patient was discharged on a postoperative day 5 without complications. The outpatient follow-up performed 1 month later showed no evidence of disease progression. Despite the use of advanced diagnostic tools, appendiceal mucocele may be confused for ovarian malignancies. Because the clinical features of appendiceal mucocele are nonspecific, clinicians and radiologists know the specific imaging findings. A multidisciplinary approach including general surgery, gynecology, and radiology is required for preoperative diagnosis and treatment.

참고문헌 (Reference)

1 Toffaha A, "What you see might not be what you get : discrepancies between intraoperative findings and preoperative diagnosis of ovarian tumors : appendicular mucocele presenting as an adnexal mass : case report and review of literature" 75 : 543-549, 2020

2 Dhage-Ivatury S, "Update on the surgical approach to mucocele of the appendix" 202 : 680-684, 2006

3 Onyishi NT, "Sclero-hyalinized low-grade appendiceal mucinous neoplasm clinically mimicking an ovarian mass" 2022 : 9404615-, 2022

4 Cubro H, "Mucocele of the appendix presenting as an exacerbated chronic tubo-ovarian abscess: a case report and comprehensive review of the literature" 98 : e17149-, 2019

5 Panarelli NC, "Mucinous neoplasms of the appendix and peritoneum" 135 : 1261-1268, 2011

6 Kumar T, "Mucinous appendiceal tumor presenting as bilateral adnexal mass" 52 : 347-350, 2021

7 Borges AL, "Low-grade mucinous appendiceal neoplasm mimicking an ovarian lesion : a case report and review of literature" 9 : 2334-2343, 2021

8 Perivoliotis K, "Low-grade appendiceal mucinous neoplasm(LAMN)primarily diagnosed as an ovarian mucinous tumor" 2021 : 5523736-, 2021

9 Tanaka H, "Low-grade appendiceal mucinous neoplasm with disseminated peritoneal adenomucinosis involving the uterus, mimicking primary mucinous endometrial adenocarcinoma : a case report" 37 : 1726-1730, 2011

10 Lee SY, "Giant appendiceal mucocele mimicking an ovarian tumour" 14 : e243753-, 2021

11 Kameda T, "Evaluation of whether the ultrasonographic onion skin sign is specific for the diagnosis of an appendiceal mucocele" 41 : 439-443, 2014

12 Gundogar O, "Evaluation of appendiceal mucinous neoplasms with a new classification system and literature review" 29 : 533-542, 2018

13 Sharma P, "Dilated appendix : is there more to it? Case report and brief review of literature with radiologic-pathological correlation" 9 : 9-, 2019

14 Dellaportas D, "Collision tumor of the appendix: mucinous cystadenoma and carcinoid: a case report" 109 : 843-845, 2014

15 Ayadi C, "Appendiceal mucocele with pseudomyxoma peritonei mimicking ovarian tumor with peritoneal carcinomatosis" 17 : 3000-3004, 2022