Appendicular mucocele

Case contributed by Mostafa Elfeky
Diagnosis almost certain


Pelvic pain

Patient Data

Age: 50
Gender: Female

MRI pelvis


Evidence of right-sided pyriform shaped pelvic cystic lesion noted posterior to the right ovary, averaging 8 x 3.5 cm showing relatively thickened enhancing wall with focal nodular mural enhancement at its lower portion. This lesion is continuous with the lumen of the cecum consistent with dilated appendix. Linear diffusion restriction noted at the cyst wall. Relative mural thickening and focal enhancement at the appendicular bases, obstructing the appendix. No periappendiceal fat stranding. No localized collections. 

Small (1.4cm) perineural cyst at S3 level.  

Case Discussion

The dilated appendix with fluid content and no surrounding inflammatory reaction is consistent with an appendicular mucocele which can be symptomatic or asymptomatic. It results from chronic appendiceal obstruction, commonly due to mucosal hyperplasia, less commonly due to mucinous neoplasms. So, Surgery is mandatory to reveal the underlying cause and to relieve symptoms.


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