Appendicular mucocele with pseudomyxoma peritonei

Case contributed by Dr Ammar Haouimi

Presentation

Five months history of right lower abdominal pain. An abdominal ultrasound done at that time revealed a ruptured right ovarian cyst (according to the ultrasound report).

Patient Data

Age: 75 years
Gender: Female

The MRI sequences reveal a well-circumscribed tubular cystic structure in the right pelvic region, contiguous with the base of the cecum. It has a low signal intensity on T1WI, high signal intensity on T2WI with thickened enhancing wall as well as an enhancing mural nodule.

Mild thickening with enhancement of the parietal peritoneum with moderate ascites around the cystic structure and in the pouch of Douglas.

Both ovaries are well-visualized, atrophied.

The MRI findings of the upper abdomen include

  • multiple simple cysts of the liver of various size
  • moderate ascites around the liver, and spleen with mild scalloping of the surface of the liver
  • enlarged spleen (14 cm) with small nodular lesions suggestive of hemangiomas (well-defined echogenic on ultrasound, not shown)
  • bilateral small simple renal cysts

Case Discussion

MRI features are most consistent of appendicular mucocele of tumoral origin with pseudomyxoma peritonei.

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Case information

rID: 69651
Published: 18th Jul 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria

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