Presentation
Right sided pain
Patient Data
MRI demonstrate cystic lesion on the right upper quadrant of abdomen. The content is homogeneous. T2 weighted sequence has hyperintense signal, whereas, T1 weighted sequence signal has hypointense signal. No any signal changes are viewed in the FAT SAT sequence. No DWI restriction.On postcontrast tomogramms there are active contrast agent uptake of front wall.
There is an L- shaped cystic tumor viewed on the right upper side, to the back of cecum area,extending upward along with ascending colon. The thickness of the walls is 4 mm. Curvilinear mural calcifications are noted on the front walls.On computed tomography the changes are well circumscribed with Hounsfield values close to that of water.
Case Discussion
The epithelial lining of the appendix consists of abundant exocrine goblet cells, and thus most tumor types seen in appendiceal samples are mucus producing.Excessive production of mucus by adenomatous tumors leads to the formation of a mucocele and is usually caused by entrapment of mucus and characterized by invasion of mucus into the appendiceal wall. Non-neoplastic or non-epithelial processes, such as inflammation or fecolith obstruction are rare causes of mucocele formation.The majority of mucoceles are fortunately benign in nature.Rupture of these tumors can however lead to dissemination of the abdominal cavity causing localized or generalized pseudomyxoma peritonei.
In this case the typical features of appendiceal mucocele are observed. So on MRI the appendiceal mucocele are viewed as cystic lesion. Hereby, T2 weihgted sequence has hyperintense signal and T1 weighted sequence has hypointense signal. As for the CT scan, the Hounsfield unit of cyst content is close to the liquid and in most cases there is curvilinear mural calcification on its wall.
For mucoceles restricted to the appendix simple appendectomy either by open or laparoscopic technique is recommended.
Unable to process the form. Check for errors and try again.