Appendiceal mucocoele

Case contributed by Dr Eric F Greif

Presentation

Abdominal pain, rule out appendicitis.

Patient Data

Age: 53
Gender: Female
CT

There is some fluid appreciated in the cecum layering dependently at the cecal apex. There is also a tubular shaped fluid filled cystic lesion appreciated on the right side of the pelvis which appears to originate at the level of the cecal apex and most likely represents a markedly dilated appendix. This measures up to 3.8 cm at the distal aspect. There is irregular calcification seen at the tip. There is no surrounding fat stranding noted. Findings are consistent with appendiceal mucocele, without rupture. 

Patient is status post hysterectomy and oophorectomy, therefore this is less likely to represent a cystic lesion of gynecologic origin.

Focal wall thickening and stricture of the terminal ileum at the ileocecal junction, most likely reflecting chronic changes of inflammatory bowel disease. No evidence for obstruction.

Case Discussion

A surgical/histoloical correlation was recommended.  Appendicectomy was performed and mucocele was proven. The appendix was significantly dilated and enlarged measuring 10cm in length and 4.8 cm in diameter. Histology demonstrated non invasive low grade appendiceal mucinous neoplasm. 

Patient has a history of Crohns disease.

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Case information

rID: 28013
Case created: 5th Mar 2014
Last edited: 17th Dec 2015
Inclusion in quiz mode: Included

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