Presentation
Lower right abdominal pain. Suspected appendicitis.
Patient Data
The appendix is markedly distended by fluid-attenuation material and contains a single small gas locule. The appendix diameter is 2.7 cm and it is surrounded by a hazy mesoappendix with prominent regional lymph nodes. No intraperitoneal fluid.
Otherwise normal appearances.
Case Discussion
The patient was referred for surgical consultation and an appendectomy was completed.
Histopathology:
no evidence of appendiceal rupture or extra-appendicular mucin.
cecal base resection margin negative for dysplastic epithelium.
additional pathological findings, acute suppurative appendicitis, and peri appendicitis.
Discussion:
Appendicular malignancies can present as a mucocele, the result of chronic obstruction. The tumor itself is typically small and often occult on CT. Bacterial overgrowth can cause inflammation and appendicitis as in this case.
The incidence of tumor as a cause of appendicitis is proportional to the age at presentation.
The case courtesy Dr. Mario Nabil Nessim and Dr Safwat Al Moghazi MD.
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