Appendix Mucocele: Case series and literature review

Darshak Shah, MD, MBBS, Ashish Padnani, MD, MBBS, Gaurav Sharma, MD, MBBS, Litong Du, MD, Saurabh Sharma, MD, MBBS. New York Hospital Queens, New York.


Appendiceal Mucocele is a very rare disease and found in only 0.3-0.4% appendectomies. It is characterized by mucoid accumulation in theappendix lumen and can present with diverse clinical features or just as an asymptomatic mass. It can be distinguished based on pathology as simple appendiceal mucocele, mucocele with epithelial hyperplasia, cystadenoma and cystadenocarcinoma. the last two are classified as neoplastic forms.
Dissemination of neoplastic cells and mucoid material in abdominal cavity by appendiceal perforation results in pseudomyxoma peritonei seen in 10-15% of cases. There exists no uniform consensus on diagnosis and treatment.

Materials and Method:
We present an interesting case series of three patients with mucocele of appendix in a community hospital in the span of one month for which one patient underwent laparoscopic assisted right hemicolectomy and 2 cases of mucocele appendix that was managed with laparoscopic appendectomy with partial cecectomy. We did extensive literature search on the topic to find out appropriate management of mucocele of appendix.

All three patients were found to have Cystadenoma of appendix.

Choice between appendectomy, appendectomy with cecectomy and right hemicolectomy is not very clearly outlined. Benign mucocele of appendix with no involvement of base can be treated with appendectomy where as cystadenocarcinoma with no metastasis and pseudomyxoma peritonei need right hemicolectomy for adequate resection.

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