Presentation
Elderly male patient presented with severe lower abdominal pain and fever for 3 days.
Patient Data
A well-circumscribed tubular-shaped fluid-filled cystic lesion (mostly representing markedly dilated appendix) is seen at the right iliac fossa region, contiguous with the base of the cecum showing smooth thickened edematous wall, curvilinear mural calcifications and few small intramural & intraluminal gas foci (mostly indicating the presence of superinfection). There is associated haziness and stranding of the surrounding mesenteric fat planes and moderate amount of pelviabdominal free fluid.
Case Discussion
Differentiating benign (non-neoplastic mucocele and mucinous cystadenoma) and malignant (mucinous cystadenocarcinoma) appendiceal lesions can be difficult on imaging, however mural nodularity and irregular wall thickening are suggestive of a malignant process.
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