101
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Gentile M, Guarino V, Mosella F, Carbone G, Beneduce L, Mosella G. [Giant mucocele of the appendix. Case report and review of the literature]. Ann Ital Chir 2008; 79:293-297. [PMID: 19093633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Mucocele is a rare pathology of the appendix characterized by expansion of the lumen for a slow storage of mucous. Represents the 0.2-0.3% of all the appendectomies. Clinical signs and the symptoms are similar to those of the acute appendicitis, while the disease is occasionally recorded and the diagnosis is essentially histological. AIM OF STUDY To recall the clinical and anatomopathological features of mucocele evaluating the possible evolutions of this rare appendicular pathology according to the updating reports of the literature. MATERIALS AND METHODS Study of a clinical case. DISCUSSION In this study diagnostic chriteria and prognostic factors are revised. Authors evaluate anatomopathological classification, possibility of evolution in a preneoplastic and neoplastic lesion and association with other colon cancers. The surgical treatment is evaluated too. CONCLUSIONS A correct preoperative mucocele diagnosis is emphasized as indispensable in the choice of the proper surgical treatment since a good prognosis is consequent to a radical treatment.
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Affiliation(s)
- Maurizio Gentile
- Dipartimento Universitario di Chirurgia Generale, Geriatria, Oncologica e Tecnologie Avanzate, Università degli Studi di Napoli Federico II.
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102
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Marte A, Sabatino MD, Cautiero P, Accardo M, Romano M, Parmeggiani P. Unexpected finding of laparoscopic appendectomy: appendix MALT lymphoma in children. Pediatr Surg Int 2008; 24:471-3. [PMID: 17628810 DOI: 10.1007/s00383-007-1957-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/18/2007] [Indexed: 10/23/2022]
Abstract
Mucosa-associated lymphoid tissue (MALT) lymphomas comprise a group of indolent B-cell non-Hodgkin lymphomas (NHL), which are rare in pediatric age. The clinical presentation of MALT lymphomas varies according to the location of the lymphoma. We report on a case of MALT lymphoma involving the appendix in a 6-year-old girl. A 6-year-old girl was referred to our institution in May 2005 with a diagnosis of appendicitis. The abdominal ultrasound showed slight effusion in the pelvic fossa. The patient underwent laparoscopic appendectomy using the three-trocar technique. The appendix appeared moderately hyperaemic with slight enlargement of the two-thirds of the distal portion. The postoperative course was uneventful and the girl was discharged on day 1 without any complication. The morphological and immunohistochemical examination showed typical findings of low-grade MALT lymphoma (positivity for CD20, no immunostaing for CD5 and CD10, positivity for anti-lambda light chain and low positivity for Ki-67). Further extensive examinations (abdominal MRI, gastroscopy, colonscopy and capsule endoscopy of the ileum) revealed that the lymphoma was limited to the distal two-third of the appendix (stage IA) and was not associated with any specific infection. At a recent follow-up the patients appeared to be doing well. Appendiceal MALToma is a rather uncommon pathology and, to our knowledge, there is only one report of appendiceal intussusception associated with appendiceal maltoma. According to our experience, low-grade MALToma can be managed by simple appendectomy. The histological examination should be the rule whenever an appendectomy is performed in children.
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Affiliation(s)
- A Marte
- Department of Paediatrics, Paediatric Surgery, Second University of Naples, S. Pansini, 5. 80131 Naples, Italy.
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103
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Abstract
The assessment and management of an acute pain crisis in the setting of advanced illness is challenging. Using the case of Mr X, a 33-year-old man with advanced metastatic mucinous adenocarcinoma of the appendix and "15 out of 10" pain, we explore the issues of acute pain and its management. We define a pain crisis as an event in which the patient reports pain that is severe, uncontrolled, and causing distress for the patient, family members, or both. Our management strategy focuses on making a pain diagnosis, differentiating reversible from intractable causes of pain, and making decisions about further workup; selecting the opioid and monitoring and treating opioid adverse effects; titrating and rotating opioid and coanalgesics; consulting experts to treat a pain crisis as quickly as possible to prevent unnecessary suffering; and co-opting the available institutional resources. The timely intervention of a palliative care team and its expertise can provide the staff, patients, and their families the benefit of an interdisciplinary approach and help the patients address goals of care; understand the benefits and risks of treatment decisions; and meet the psychological, social, and existential needs of the patient and the family commonly seen in this setting.
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104
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Hibi K, Mizutani M, Imazawa M, Nakamura T, Nonoyama M, Shibata H. Mucinous cystadenoma of the appendix associated with muscular and neuromatous hyperplasia: report of a case. Nagoya J Med Sci 2008; 70:35-40. [PMID: 18807294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Mucinous cystadenoma of the appendix is a type of appendiceal mucocele and a rather rare condition usually found incidentally in the course of other abdominal surgery. A previous evaluation of 73 appendiceal mucoceles showed that this disease was often associated with adenocarcinoma and other epithelial atypia. This observation suggested that patients with mucinous cystadenoma of the appendix also have some underlying disorders. However, non-epithelial changes associated with appendiceal mucocele have not been reported so far. In this study, we presented for the first time a mucinous cystadenoma of the appendix associated with muscular and neuromatous hyperplasia.
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Affiliation(s)
- Kenji Hibi
- Department of Surgery, Showa University Fujigaoka Hospital, Yokohama 227-8501, Japan.
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105
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Abstract
Acute abdominal pain may be attributed to a variety of medical or surgical conditions. Acute appendicitis, a common entity in differential diagnosis, may present with diverse clinical manifestations. It may occasionally mimic urogenital disorders and be particularly challenging to diagnose in women. We report a 34-year-old woman who had undergone radical hysterectomy 2 years previously for stage Ib cervical cancer. She presented with lower abdominal pain, dysuria, and fever of 2 days duration, unrelieved by 5 days of antibiotics. Computed tomography revealed an enlarged appendix surrounded by an abscess, and appendectomy was performed. Pathologic examination of the surgical specimen revealed metastatic cervical cancer in the appendix. Patients with acute appendicitis may manifest with urologic disorders that can be caused by metastatic tumor.
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Affiliation(s)
- Ming-Jong Bair
- Department of Internal Medicine, Mackay Memorial Hospital, Taitung Branch, Taitung, Taiwan
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106
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Chatti S, Ben Brahim E, Sidhom O, Ben Othman M, Zidi Y, Salah MB, Sassi S, Regaya SM, Touinsi H. [Comparative study of appendical mucocela and pseudomyxoma peritonei. About 25 cases]. Tunis Med 2007; 85:1044-1049. [PMID: 19170385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AIM to study the clinicopathological features of the different types of appendical mucocele and to compare them with those of pseudomyxoma peritonei. METHODS 25 cases of appendical mucocele were operated in the Cap-Bon region in Tunisia during a period of 13 years from 1994 to 2006. RESULTS 9 retentionnal cysts, 13 mucinous cystadenomas, one serrated adenoma, one hyperplasia of the mucosa and one cystadenocarcinoma were diagnosed. Five cystadenomas as well as the only case of cystadenocarcinoma were associated with pseudomyxoma peritonei. Pseudomyxoma peritonei occurred 20 years later than in simple appendiceal mucocèle and complicated 5 cases of cystadenoma with low grade dysplasia and 1 case of cystadenocarcinoma. CONCLUSION Preoperative diagnosis of appendical mucocele and pseudomyxoma peritonei should be made on scannographic features in order to assess the adequate surgical management.
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Affiliation(s)
- Samia Chatti
- Service d'Anatomie et de Cytologie Pathologiques, Service de Chirurgie, Hôpital MT Maâmouri, Route de Mrezka, 8000, Nabeul, Tunisie
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107
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Feki W, Ghozzi S, Damak T, Dridi M, Khiari R, Rahal K, Ben Rais N. Recurrent obstructions after resonance stent placement in the treatment of ureteral compression from malignant disease. Tunis Med 2007; 85:1058-1060. [PMID: 19170387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND The Resonance ureteral stent is a newly developed all-metallic double-pigtail ureteral stent allowing a palliative diversion on a patient with malignant ureteral obstruction. AIM To define selection criteria of good candidates for Resonance stent. CASE A 62-year-old woman was admitted to the emergency department with complaining of severe right flank pain and anuria. Twelve days earlier, we had placed retrogradely a ureteral metallic Resonance stent (Resonance; Cook Ireland Ltd,Limerick, Ireland) for the treatment of a ureteral compression from pelvic recurrence of an appendical colloid mucosal carcinoma in a solitary functioning right kidney. A percutaneous nephrostomy catheter was placed, and an antegrade nephrostogram demonstrated complete distal ureter obstruction. The patency of the ureteral stent was restored spontaneously and then, nephrostomy catheter was removed. Two weeks later, she presented with obstructed ureteral stent. Percutaneous nephrostomy was performed and Resonance stent was removed definitively. Ureteroscopy with biopsy confirmed the tumour extension into the ureteral lumen. CONCLUSION The risk of subsequent obstruction after Resonance metallic ureteral stent placement is real. Patients with intra-ureteral tumour extension are presumably not good candidates for Resonance stent management.
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Affiliation(s)
- Wassim Feki
- Military Hospital, Urology Department, Tunis
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108
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Edden Y, Shussman N, Amir G, Pruss D, Rojansky N, Pikarsky AJ. Villous adenoma after appendiceal uterine transplantation. Int J Gynaecol Obstet 2007; 100:83-4. [PMID: 17888436 DOI: 10.1016/j.ijgo.2007.06.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2007] [Revised: 06/15/2007] [Accepted: 06/21/2007] [Indexed: 11/19/2022]
Affiliation(s)
- Y Edden
- Department of General Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
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109
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110
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Papandreou E, Gentimi F, Baltogiannis N, Tzovaras A, Geroulanos-Christopoulos G, Karamolegou K, Stephanaki K, Moschovi M. Nonendemic Burkitt lymphoma presenting with an atypical clinical picture. J Pediatr Hematol Oncol 2007; 29:661-3. [PMID: 17805048 DOI: 10.1097/mph.0b013e3181468c7f] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Primary appendiceal Burkitt lymphomas are rare occurring in 0.015% of all gastrointestinal lymphomas. Presentation of such lymphomas with peritonitis and obstructive jaundice owing to its subhepatic location is even more unusual. Burkitt lymphoma is very rare in children below 5 years old. We will present a 3-year-old boy with primary appendiceal lymphoma whose first symptom was obstructive jaundice caused by a ruptured retrocecal subhepatic appendix which in essence is a combination of all 3 mentioned occurrences complicated with acute abdomen.
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Affiliation(s)
- Evangelos Papandreou
- 2nd Department of Pediatric Surgery, Hematology-Oncology Unit, Athens University Medical School, Pathology Department, Aghia Sophia Children's Hospital, Athens, Greece.
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111
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Abstract
BACKGROUND Acute appendicitis is a frequently encountered entity in emergency surgery. Incidental findings as Meckel's diverticulum or Crohn's disease during this operation are not uncommon. METHODS Laparotomy revealed a perforated appendix with an incidental Meckel's diverticulum and thickened distal small bowel with fat encroaching the mesentery suggestive of active Crohn's disease. A routine appendicectomy was done and pathology revealed inflamed perforated appendix with an incidental carcinoid within the appendix. CONCLUSIONS Presence of active Crohn's disease along with an incidental Meckel's diverticulum or acute appendicitis raises controversies in their surgical management. We discuss the issues in managing patients with two or more of these co-existent pathologies.
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Affiliation(s)
- A L Gidwani
- Department of General Surgery, Daisy Hill Hospital, 5 Railway Road, Newry, BT35 8DR, Northern Ireland.
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112
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Suppiah A, Barandiaran J, Morgan R, Perry EP. First case of villous adenoma of the appendix leading to acute appendicitis presenting as strangulated femoral hernia: changes in management owing to concurrent adenoma. Hernia 2007; 12:95-8. [PMID: 17566835 DOI: 10.1007/s10029-007-0245-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2006] [Accepted: 04/26/2007] [Indexed: 11/24/2022]
Abstract
A 78-year-old lady presented with signs and symptoms of a strangulated femoral hernia. Peri-operatively she was found to have appendicitis within the hernia sac. Appendicectomy and non-mesh hernia repair were performed. Histology revealed acute inflammation and a villous adenoma of the appendix. Villous adenomas of the vermiform appendix are extremely rare tumours of the gastrointestinal tract. This is the first case combining two very rare pathologies--acute appendicitis presenting as strangulated femoral hernia and villous adenoma of the appendix. Early diagnosis and surgery are required to avoid high morbidity of perforated appendicitis within a femoral hernia. First, we discuss the diagnosis and surgical treatment of acute appendicitis within a femoral hernia. Second, the presence of an adenoma changes the aetiology of appendicitis. More importantly, changes in surgical management of acute appendicitis presenting as a strangulated femoral hernia owing to a co-existing adenoma are discussed.
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Affiliation(s)
- A Suppiah
- Academic Surgical Unit, Castle Hill Hospital, Cottingham, East Yorkshire HU16 5JQ, UK.
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113
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Tahan G, Koc I, Tetikkurt US, Yucel O. Mucinous tumor of uncertain malignant potential in a perforated appendectomy specimen. A case report. J Gastrointestin Liver Dis 2007; 16:197-200. [PMID: 17592571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Mucinous tumors of uncertain malignant potential are rare; there are only occasional reports. We report the first case where the tumor was identified incidentally following resection of a perforated appendicitis. There was no previous history to suggest for a mucinous tumor. No other abnormalities were found at surgery. Treatment included right hemicolectomy, considering the risk of residual or metastatic disease of about 10%. The patient is alive and well twelve months after resection of the tumor.
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Affiliation(s)
- Gulgun Tahan
- Unit of Surgery, Marmara University Institute of Gastroenterology.
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114
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115
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Affiliation(s)
- Thara Persaud
- Department of Radiology, Adelaide and Meath Incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland
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116
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González-Moreno S, Lambert LA, Mansfield PF. Interstitial pneumonitis: an exceptional toxicity of hyperthermic intraperitoneal mitomycin C. Eur J Surg Oncol 2007; 34:482-4. [PMID: 17434283 DOI: 10.1016/j.ejso.2007.02.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2007] [Accepted: 02/19/2007] [Indexed: 11/27/2022] Open
Affiliation(s)
- S González-Moreno
- Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Box 444, Houston, TX 77030, USA
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117
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Ghidirim G, Gagauz I, Mişin I, Canariov M, Ionesii P, Zastavnitchi G. [Mucinous cystadenocarcinoma of the appendix complicated with spontaneous cutaneous fistula]. Chirurgia (Bucur) 2007; 102:231-5. [PMID: 17615929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Mucocele of the appendix is a relatively rare disease characterized by a cystic dilatation of the appendiceal lumen with stasis of mucus inside. Appendiceal mucocele with a cutaneous fistula is an extremely rare clinical entity, only four such cases being described in the medical literature. We report an additional case of cystadenocarcinoma of the appendix with spontaneous cutaneous fistula. The patient is an 80-year old woman, who originally presented with a skin ulcer in the right lower abdominal quadrant with mucus discharge during the last month. Abdominal ultrasonography and computed tomography demonstrated cystic mass with mixed echogenity and density originating from the appendix, involving the abdominal wall, without signs of ascites or metastasis. A right hemi-colectomy, lymphadenectomy and resection of the skin fistula was performed. The histological findings revealed moderately differentiated mucinous cystadenocarcinoma of the appendix. The postoperative period was uneventful and the patient discharged on the 11th POD. During 12 month follow-up period the patient is free of disease recurrence. The authors present the literature review, diagnostic features and the treatment policy of this extremely rare condition.
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Affiliation(s)
- G Ghidirim
- Catedra Chirurgie nr. 1 N. Anestiadi şi Laboratorul de Chirurgie Hepato-Bilio-Pancreatică, Universitatea de Medicină şi Farmacie N. Testemiţanu, Spitalul Clinic Municipal de Urgenţă, Chişinău, Moldova
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118
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Koornstra JJ, Schot BW, Dijkstra G. Mantle cell lymphoma involving the appendiceal orifice as an unusual cause of lower gastrointestinal bleeding. Int J Colorectal Dis 2007; 22:99-100. [PMID: 16189691 DOI: 10.1007/s00384-005-0039-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2005] [Indexed: 02/04/2023]
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119
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Abstract
Sessile serrated adenoma is a relatively recently described entity that can occur in the appendix. The incidence of this finding is unknown. We entirely submitted 100 consecutive appendices sent for acute appendicitis and correlated the histologic findings with clinical parameters and the findings in 100 routinely (partially) submitted cases. In cases submitted routinely, only 1 sessile serrated adenoma was found. In contrast, in cases entirely submitted, 11 adenomas were found, all in patients 30 years or older. All sessile serrated adenomas were present in 3 cross-sections or fewer of the appendix. The incidence of sessile serrated adenoma in patients with acute appendicitis is significantly increased in patients 30 years or older (P = .001), and detection is dependent on thorough tissue sampling.
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Affiliation(s)
- Andrew A Renshaw
- Department of Pathology, Baptist Hospital of Miami, Miami, FL 33176, USA
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120
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Louzi A, Nargis Y, Belaabidia B, Alatawna H, Benelkhaiat R, Finech B, Dafali AE. Mucocèle de l'appendice sur tumeur carcinoïde pendant la grossesse. ACTA ACUST UNITED AC 2006; 34:1051-4. [PMID: 17052936 DOI: 10.1016/j.gyobfe.2006.07.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2006] [Accepted: 07/04/2006] [Indexed: 10/24/2022]
Abstract
Mucocele of the appendix secondary to appendicular carcinoid tumour is a rare entity. It occurs exceptionally during pregnancy. The interaction between carcinoid tumour or mucocele of the appendix and pregnancy is not yet elucidated. Prognosis depends on the size of the carcinoid tumour and its regional invasion. We report a case of appendicular mucocele caused by a carcinoid tumour in a 36-year-old pregnant woman who had been admitted because of acute appendicitis. Pathological examination of the appendicectomy specimen revealed a carcinoid tumour measuring 2 cm. Right hemicolectomy was performed two weeks after delivery with good evolution. According to this case and depending on the literature, the authors discuss the diagnosis and the therapeutic modalities proposed for this rare entity.
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Affiliation(s)
- A Louzi
- Service de chirurgie viscérale, CHU Mohamed-VI, BP 7010, Sidi-Abbad 40000 Marrakech, Maroc.
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121
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Lee YT, Wu HS, Hung MC, Lin ST, Hwang YS, Huang MH. Ruptured appendiceal cystadenoma presenting as right inguinal hernia in a patient with left colon cancer: a case report and review of literature. BMC Gastroenterol 2006; 6:32. [PMID: 17074081 PMCID: PMC1634861 DOI: 10.1186/1471-230x-6-32] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2006] [Accepted: 10/30/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mucoceles resulting from cystadenomas of the appendix are uncommon. Although rare, rupture of the mucoceles can occur with or without causing any abdominal complaint. There are several reports associating colonic malignancy with cystadenomas of the appendix. Herein, we report an unusual and interesting case of right inguinal hernia associated with left colon cancer. CASE PRESENTATION A case of ruptured mucocele resulting from cystadenoma of the appendix was presented as right inguinal hernia in a 70-year-old male. The patient underwent colonoscopy, x-ray, ultrasound and computed tomography. Localized pseudomyxoma peritonei associated with adenocarcinoma of the descending colon was diagnosed. The patient underwent segmental resection of the colon, appendectomy, debridement of pseudomyxoma and closure of the internal ring of right inguinal canal. He is free of symptoms in one year follow-up. CONCLUSION Synchronous colon cancer may occur in patients with appendiceal mucoceles. In such patients, the colon should be investigated and colonoscopy can be performed meticulously in cases of ruptured mucoceles and localized pseudomyxoma peritonei. Surgical intervention is the current choice of management.
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Affiliation(s)
- Yueh-Tsung Lee
- Department of Surgery, Division of general surgery, Chang-Bing Show Chwan Memorial Hospital, Lu-Gang, Taiwan
| | - Hurng-Sheng Wu
- Department of Surgery, Division of general surgery, Chang-Hua Show Chwan Memorial Hospital, Chang-Hua, Taiwan
| | - Min-Chang Hung
- Department of Surgery, Division of general surgery, Chang-Hua Show Chwan Memorial Hospital, Chang-Hua, Taiwan
| | - Shang-Tao Lin
- Department of Pathology, Chang-Hua Show Chwan Memorial Hospital, Chang-Hua, Taiwan
| | - Yome-Shine Hwang
- Department of Surgery, Division of general surgery, Chang-Hua Show Chwan Memorial Hospital, Chang-Hua, Taiwan
| | - Min-Ho Huang
- Department of Surgery, Division of general surgery, Chang-Hua Show Chwan Memorial Hospital, Chang-Hua, Taiwan
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122
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Affiliation(s)
- Tristan D Yan
- Peritoneal Surface Malignancy Program, Washington Cancer Institute, Washington, DC, USA
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123
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Sambol E, Patterson D, Rivera R, Borys D, Greco MA, Kaul A, Nadler EP. An appendiceal leiomyoma in a child with acquired immunodeficiency syndrome. Pediatr Surg Int 2006; 22:865-8. [PMID: 16944181 DOI: 10.1007/s00383-006-1773-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/14/2006] [Indexed: 12/28/2022]
Abstract
Children with acquired immunodeficiency syndrome (AIDS) are at an increased risk for lymphoproliferative and neoplastic disorders. Included among these are smooth muscle neoplasms such as leiomyomas and leiomyosarcomas. There have been at least 15 reported cases of smooth muscle tumors in the approximately 8,000 children with AIDS, however the incidence in immunocompetent children is only two per ten million. The lesions in children with human immunodeficiency virus infection are usually found in the lung, liver, and gastrointestinal tract. Here, we present an unusual case of a 12-year-old African American girl with vertically acquired AIDS who presented to the pediatric emergency department with severe diffuse abdominal pain. She was ultimately found to have an appendiceal leiomyoma on abdominal exploration, the first reported case. Our report suggests that smooth muscle tumors of the appendix be included in the differential diagnosis of abdominal masses in children with AIDS.
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Affiliation(s)
- Elliot Sambol
- Division of Pediatric Surgery, Department of Surgery, New York University School of Medicine, 530 First Avenue, Suite 10 W, New York, NY 10016, USA
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124
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Butte JM, Torres J, Henríquez IM, Pinedo G. Appendicular mucosal intussusception into the cecum secondary to an intramural mucinous cystoadenoma of the appendix. J Am Coll Surg 2006; 204:510. [PMID: 17324789 DOI: 10.1016/j.jamcollsurg.2006.07.046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2006] [Revised: 07/11/2006] [Accepted: 07/20/2006] [Indexed: 11/16/2022]
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125
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Shiwani MH. Primary malignant lymphoma of the appendix associated with acute appendicitis. J Coll Physicians Surg Pak 2006; 16:79-80. [PMID: 16442000 DOI: 1.2006/jcpsp.7980] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/16/2005] [Accepted: 09/13/2005] [Indexed: 11/13/2022]
Abstract
Malignant lymphoma comprises 1-4% of the malignant neoplasm of the gastrointestinal tract. Appendiceal lymphomas are extremely rare, reported in 0.015 percent of all gastrointestinal lymphomas. This is a report of a case of localized malignant lymphoma of the appendix associated with the histological features of acute inflammation that presented clinically as acute appendicitis. A three years follow-up after appendectomy alone did not show any evidence of recurrent disease. This case report emphasizes the importance of routine histology examination of the appendectomy specimen.
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Affiliation(s)
- Muhammad Hanif Shiwani
- Department of General Surgery, Barnsley District General Hospital, Barnsley, South Yorkshire, UK.
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126
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Abstract
A 37-year-old woman presented with acute right lower abdominal pain. Intraoperatively, the appendix was enlarged and distended. The lumen of the appendix was tightly filled with pearl-like globules, diagnostic of myxoglobulosis, a rare variant of mucocele of the appendix. A carcinoid of 2.0 cm diameter was found in the proximal region of the appendix. The appendiceal mucosa showed hyperplastic-adenomatous changes. A pseudodiverticulum interpreted as evidence of increased intraluminal pressure was detected. The latter may be an adjunct to the proximal partial obstruction of the appendiceal lumen by the carcinoid in the development of the spheroids of myxoglobulosis.
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Affiliation(s)
- Hermann Brustmann
- Department of Pathology, Thermenklinikum, Moedling, Vienna, Austria.
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127
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128
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Affiliation(s)
- N Ueno
- Division of Endoscopy, Yokohama City University Hospital, 3-9, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
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129
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Tynan JR, Marshall GB, Gray RR. Answer to case of the month #107. Appendiceal mucocele as a presentation of mucinous adenocarcinoma. Can Assoc Radiol J 2006; 57:117-9. [PMID: 16944685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Affiliation(s)
- Jennifer R Tynan
- Department of Diagnostic Imaging, Foothills Medical Centre, Calgary, AB
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130
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Djuranovic SP, Spuran MM, Kovacevic NV, Ugljesic MB, Kecmanovic DM, Micev MT. Mucinous cystadenoma of the appendix associated with adenocarcinoma of the sigmoid colon and hepatocellular carcinoma of the liver: report of a case. World J Gastroenterol 2006. [PMID: 16610012 DOI: 10.1016/s0893-9659(98)00180-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Mucinous cystadenoma of the appendix is a rare condition and represents one of the three entities with the common name mucocele of the appendix. It is characterized by a cystic dilatation of the lumen with stasis of mucus inside it. Histopathologically mucocele is divided into three groups: focal or diffuse mucosal hyperplasia, mucinous cystadenoma and mucinous cystadenocarcinoma. This condition is often associated with other neoplasia, especially adenocarcinoma of the colon and ovaries. We here describe a 57 year old male patient who presented with abdominal discomfort, constipation, fresh blood in stool and frequent urination. He had a big cystadenoma of the appendix associated with adenocarcinoma of the colon and hepatocellular carcinoma of the liver. The patient underwent right haemicolectomy, sigmoid colon resection and segmental resection of the liver. Now 3 years later he has no evidence of disease relapse. According to this, we stress the need of accurate preoperative diagnosis and intraoperative exploration of the whole abdomen in these patients.
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Affiliation(s)
- Srdjan P Djuranovic
- Institute for Digestive Diseases, Clinical Center of Serbia, K. Todorovica St. No 6, 11000 Belgrade, Serbia and Montenegro.
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131
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Djuranovic SP, Spuran MM, Kovacevic NV, Ugljesic MB, Kecmanovic DM, Micev MT. Mucinous cystadenoma of the appendix associated with adenocarcinoma of the sigmoid colon and hepatocellular carcinoma of the liver: Report of a case. World J Gastroenterol 2006; 12:1975-7. [PMID: 16610012 PMCID: PMC4087531 DOI: 10.3748/wjg.v12.i12.1975] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Mucinous cystadenoma of the appendix is a rare condition and represents one of the three entities with the common name mucocele of the appendix. It is characterized by a cystic dilatation of the lumen with stasis of mucus inside it. Histopathologically mucocele is divided into three groups: focal or diffuse mucosal hyperplasia, mucinous cystadenoma and mucinous cystadenocarcinoma. This condition is often associated with other neoplasia, especially adenocarcinoma of the colon and ovaries. We here describe a 57 year old male patient who presented with abdominal discomfort, constipation, fresh blood in stool and frequent urination. He had a big cystadenoma of the appendix associated with adenocarcinoma of the colon and hepatocellular carcinoma of the liver. The patient underwent right haemicolectomy, sigmoid colon resection and segmental resection of the liver. Now 3 years later he has no evidence of disease relapse. According to this, we stress the need of accurate preoperative diagnosis and intraoperative exploration of the whole abdomen in these patients.
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Affiliation(s)
- Srdjan P Djuranovic
- Institute for Digestive Diseases, Clinical Center of Serbia, K. Todorovica St. No 6, 11000 Belgrade, Serbia and Montenegro.
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132
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Bronzino P, Abbo L, Bagnasco F, Barisone P, Dezzani C, Genovese AM, Iannucci P, Ippoliti M, Sacchi M, Aimo I. [Appendiceal mucocele due to mucinous cystadenoma: case report and review of the literature]. G Chir 2006; 27:97-9. [PMID: 16681869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Mucinous cystadenomas of the appendix are rare tumours. In this article we describe the case of a young woman who presented with abdominal pain and a clinical pattern likely to a chronic appendicitis. At laparotomy we found a dilatation of the appendix which contained an abundant quantity of mucus. Histological examination showed a mucinous cystadenoma of the appendix. This neoplasm requires a surgical treatment, usually only appendectomy and right hemicolectomy in case of involvement of the caecum. During operation, the surgeon must take care in handling the appendix because of the risk of rupture with consequent dissemination of epithelial cells in the peritoneal cavity (pseudomyxoma peritonei).
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Affiliation(s)
- P Bronzino
- Struttura Complessa Chirurgia Generale, Ospedale Santa Croce, Mondovi (CN)
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133
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Rezkalla MA, Peterson KG, Ryan JJ. Pseudomyxoma peritonei: a case of mucinous adenocarcinoma of the appendix presenting as inguinal hernia. S D Med 2006; 59:54-5, 57. [PMID: 16519367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Pseudomyxoma peritonei is a rare neoplastic condition characterized by diffuse collections of gelatinous fluid associated with mucinous implants on the peritoneal surfaces and omentum. Typical presentations include suspected acute appendicitis, increasing abdominal girth, new onset hernia and in women, an ovarian mass. The exact pathological origin, classification, and ideal treatment have been the subject of debate in the literature. Although optimum treatment is debatable, most expert opinion favors extensive surgical debulking with or without adjuvant therapy. We present a case of a 51-year-old man who presented with an inguinal hernia that was, in fact, secondary to pseudomyxoma peritonei. It is best practice, we believe, that any mucoid fluid encountered during hernia repair should be recovered and, along with the hernial sac, be assessed histologically.
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134
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135
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Cois A, Pisanu A, Pilloni L, Uccheddu A. Intussusception of the appendix by mucinous cystadenoma. Report of a case with an unusual clinical presentation. Chir Ital 2006; 58:101-4. [PMID: 16729616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Appendiceal mucocele is a very rare clinical condition. Associated ascites and an ovarian mass could suggest synchronous ovarian cystadenocarcinoma with pseudomyxoma peritonei. We describe the case of a 36-year-old female with a mucinous cystadenoma of the appendix causing intussusception, diagnosed by CT but not by US scan, since the associated anomalous fixation of the caecum was misleading in defining the precise anatomical site. Although the CT findings were accurate, the synchronous presence of an ovarian cyst and ascites did not allow us to rule out preoperatively a concurrent cystadenocarcinoma of the ovary with pseudomyxoma peritonei. The appropriate surgical treatment was performed on the basis of intraoperative frozen section examination. Surgical treatment depends on the nature of the mucocele: retention forms are effectively treated by appendectomy, while neoplastic conditions require a more extended resection. Treatment of associated ovarian cystadenocarcinoma and pseudomyxoma peritonei includes right colectomy, bilateral ovariectomy and omentectomy. Although a precise preoperative diagnosis of mucocele associated with intussusception of the appendix has been reported as possible, concomitant ascites and ovarian masses, as in the present case, could mimic pseudomyxoma peritonei from concurrent ovarian cystadenocarcinoma. Intraoperative histopathology is required in order to perform the most appropriate treatment.
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Affiliation(s)
- Alessandro Cois
- Dipartimento Chirurgico, Materno Infantile e di Scienze delle Immagini, Semeiotica Chirurgica, Università di Cagliari
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136
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Savchenko IP, Polovinkin VV, Fedosov SR, Pryn' PS. [Combination of giant mucocele of the appendix and adenocarcinoma of the rectum]. Khirurgiia (Mosk) 2006:57-9. [PMID: 17167911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
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137
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Abstract
Mucocele of the appendix is a thin-walled dilated appendix filled with mucus. It occurs secondary to chronic obstruction of the appendiceal lumen because of a range of pathologies. Cystadenomas in children are exceedingly rare and most frequently of ovarian origin. A mucous cystadenoma of the appendix in a 10-year-old boy with chronic abdominal pain is presented.
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Affiliation(s)
- Matthew J Blecha
- Department of Pediatric Surgery, Children's Memorial Hospital, Chicago, IL 60657, USA.
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138
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Abstract
OBJECTIVE We discuss the case of a 58-year-old woman who presented with right lower quadrant pain and fever. CT showed a right lower quadrant inflammatory mass presumed to be an appendiceal abscess. The patient underwent open drainage of the mass but failed to return for an interval appendectomy. She returned 23 months later with a recurrent right lower quadrant inflammatory mass treated initially with percutaneous drainage followed by interval appendectomy. The final pathologic diagnosis was mucinous cystadenoma with perforation. CONCLUSION Primary neoplasms of the appendix are uncommon but should be considered in the correct clinical and imaging scenario.
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Affiliation(s)
- Michelle M Bittle
- Department of Radiology, University of Washington, Harborview Medical Center, 325 Ninth Ave., Box 359728, Seattle, WA 98104-2499, USA.
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139
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Abstract
We report a case involving a 55-year-old healthy man that presented with urinary retention and a lower abdominal mass. His evaluation revealed a large mucocele arising from the appendix that caused severe bilateral ureteral obstruction and renal failure. Appendiceal mucoceles are rare and insidious entities that can present with urologic manifestation. Despite their rarity, this case highlights the importance of including mucoceles in the differential diagnosis in cases involving ureteral obstruction caused by external compression.
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Affiliation(s)
- Pedram Ilbeigi
- Department of Surgery, UMDNJ- New Jersey Medical School, Newark, NJ 07601, USA
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140
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Persaud T, Buckley O, Geoghegan T, Mc Court T, Swan N, Torreggiani W. Giant mucinous cystadenoma of the appendix presenting with contralateral ilio-femoral deep venous thrombosis (2005: 7b). Eur Radiol 2005; 15:2212-3. [PMID: 16252365 DOI: 10.1007/s00330-005-2787-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- T Persaud
- AMNCH Tallaght Hospital Radiology, Dublin, Ireland
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141
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Abstract
Mucocele of the appendix is a rare lesion, characterized by distension of the lumen due to accumulation of mucoid substance. This disease is often asymptomatic and pre-operative diagnosis is rare. If untreated, one type of mucocele may rupture producing a potentially fatal entity known as pseudomyxoma peritonei. The type of surgical treatment is related to the dimensions and to histology of the mucocele. Appendectomy is used for simple mucocele or for cystadenoma. Right hemi-colectomy is recommended for cystadenocarcinoma. In this paper, we report a case of a 51-year-old woman with a mobile, painless mass in the right lower quadrant of abdomen caused by a giant appendiceal mucocele. Imaging showed a large, tubular, cystic structure extending below from the inferior wall of the cecum. Surgery revealed a giant retro-cecal appendix measuring 17 cm in length and 4 cm in diameter. The final pathologic diagnosis was mucocele caused by mucinous cystadenoma.
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Affiliation(s)
- Bernardino Rampone
- Department of General Surgery and Surgical Oncology, University of Siena, Italy
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142
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Abstract
We report a case of acute appendicitis due to recurrent metastatic gastric adenocarcinoma involving only appendix, without the evidence of abdominal carcinomatosis 2 years after initial diagnosis of the primary gastric lesion. This case, in contrast to other previously reported cases that carried a dismal prognosis, had survived without tumour recurrent for more than 1 year after appendectomy, while this report was made.
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Affiliation(s)
- C Y Lin
- Department of Pathology, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC
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143
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Affiliation(s)
- D Kulkarni
- Tyrone county Hospital, Omagh, Northern Ireland.
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144
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Karabulut R, Sönmez K, Türkyilmaz Z, Yilmaz Y, Akyürek N, Başaklar AC, Kale N. Mucosa-associated lymphoid tissue lymphoma in the appendix, a lead point for intussusception. J Pediatr Surg 2005; 40:872-4. [PMID: 15937835 DOI: 10.1016/j.jpedsurg.2005.02.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Abstract Appendiceal intussusception and mucosa-associated lymphoid tissue lymphoma are both uncommon entities, and this is the first report of the two occurring concomitantly in an 8-year-old boy. This report of a mucosa-associated lymphoid tissue lymphoma localized in the appendix has not been reported previously.
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Affiliation(s)
- Ramazan Karabulut
- Department of Pediatric Surgery, Faculty of Medicine, Gazi University, Ankara 06500, Turkey.
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145
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Korkontzelos I, Papanicolaou S, Tsimoyiannis I, Kitsiou E, Stefos T, Tsanadis G, Antoniou N. Large carcinoid tumor of the appendix during pregnancy. Eur J Obstet Gynecol Reprod Biol 2005; 118:255-7. [PMID: 15653215 DOI: 10.1016/j.ejogrb.2004.07.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2003] [Revised: 07/11/2004] [Accepted: 07/14/2004] [Indexed: 11/17/2022]
Abstract
Diagnosis of acute appendicitis is considered more difficult in pregnant than in non-pregnant women. The appendicial carcinoid tumor is a lesion that most frequently is discovered incidentally in the removed organ. We report a rare case of an unruptured acute appendicitis during pregnancy, which proved to be a large carcinoid tumor.
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Affiliation(s)
- Ioannis Korkontzelos
- Department of Obstetrics and Gynecology, District General Hospital of Ioannina "G. Chatzikosta", Alexandrou Drakou 2, 45221 Ioannina, Greece.
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146
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Lakatos PL, Gyori G, Halasz J, Fuszek P, Papp J, Jaray B, Lukovich P, Lakatos L. Mucocele of the appendix: An unusual cause of lower abdominal pain in a patient with ulcerative colitis-. A case report and review of literature. World J Gastroenterol 2005; 11:457-9. [PMID: 15637769 PMCID: PMC4205363 DOI: 10.3748/wjg.v11.i3.457] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The authors report the case of a 60-year-old male patient. In November 2001 he developed intestinal symptoms of bloody diarrhea and abdominal pain. Colonoscopy and biopsy established the diagnosis of ulcerative colitis (proctosigmoiditis). The disease activity was moderate at the beginning. No significant laboratory alterations were found (including CEA, CA19-9), and mesalazine was started orally. He was in remission until November 2003, when he was admitted to our Outpatient Clinic for upper and right lower abdominal pain and bloody diarrhea. Colonoscopy found proctosigmoiditis with a moderate activity, gastroscopy revealed chronic gastritis, laboratory data was normal. Treatment was amended with mesalazine clysma and methylprednisolone (16 mg) orally. Symptoms ameliorated; however, right lower abdominal pain persisted. US and CT examination demonstrated a pericecal cystic mass (11 cm×3.5 cm). At first pericecal abscess was suspected, as the previous US examination (6 mo earlier) had revealed normal findings. Fine needle aspiration was performed. Cytology confirmed the diagnosis of mucocele. The patient underwent partial cecum resection and extirpation of the mucocele. He recovered well and the final histology revealed a cystadenoma of the appendix. Follow up was started. The patient is now free of symptoms. Although primary adenocarcinoma of the appendix is uncommon, the authors emphasize that preoperative diagnosis of an underlying malignancy in a mucocele is important for patient management; however, it is difficult on imaging studies.
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147
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Abstract
We previously read with interest the case report by Filik et al. (International Journal of Gastrointestinal Cancer, 2003;34:55-58) on appendicular metastases from pancreatic adenocarcinoma. We would like to share our recent experience.A 64-yr-old man presented with a 2-d history of progressively increasing colicky abdominal pain and fever. His past medical history included a pneumonectomy of the left lung for locally advanced lung adenocarcinoma 9 mo previously. TNM stage of the original lung cancer was T2N2M0. On examination, his abdomen was slightly distended and he had an intermittent metallic bowel sound. Abdominal CT scan showed a low-density mass, 3 cm in diameter, in the right pelvic cavity. Endoscopic evaluation revealed no obstruction, but failed to identify mucosal abnormalities in the ileocecal region. Chest CT scan prior to surgery did not show any evidence of pulmonary recurrence or metastasis. He underwent a laparotomy, and tumor of the appendix, 3 x 3 cm in diameter, adhered to the surrounding tissue, but no perforation was seen. The mass was excised in combination with an ileocecal resection, followed by ileocolic anastomosis. Hisotologically, the neoplastic tumor cells infiltrated the submucosa, muscularis, and serosa, but mucosa of the appendix was intact, unremarkable, with no precursor lesion. The tumor was morphologically similar to the lung primary tumor. The patient had an uneventful postoperative course. He was examined at regular periodic follow-ups, but died from lung cancer 12 mo after the resection of the metastatic tumor to the appendix.
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Affiliation(s)
- Kunihiko Miyazaki
- Division of Respiratory Medicine, Institute of Clinical Medicine, University of Tsukuba, Tsukuba-city, Ibaraki, Japan
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148
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Abstract
The purpose of this study was to use descriptive methodology to study the management of patients with pseudomyxoma peritonei (PMP) at the Princess Margaret Hospital. This is a case series of patients with a diagnosis of PMP treated between January 1, 1995 and December 31, 2001. A health record search using the morphology code for PMP was done and identified 70 patients. Additionally, an unrestricted Medline search was conducted between 1990 and 2002 for PMP. Eight cases of PMP were treated by the Gynecologic Oncology service at Princess Margaret Hospital during the study period. The patients ranged in age from 43 to 84 and presented with a pelvic mass and/or increasing abdominal girth. All but two patients underwent appendectomy as part of their surgery. Postoperative management was by gynecologic oncology for seven of eight patients. An appendiceal origin was confirmed for six patients and highly suspicious for one patient. The remaining patient underwent appendectomy, but it was not sufficiently sectioned for diagnosis. Chemotherapy was given to patients in a non-uniform fashion. Removal of mucinous tumors of the ovary should include appendectomy. Consultation from a general surgical oncologist should be sought where appendiceal origin is confirmed. Coding errors may occur in medical records at a frequency greater than is anticipated.
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Affiliation(s)
- M L Hopkins
- Division of Gynecologic Oncology, University of Ottawa, 501 Smyth Road, Room 8130, Ottawa, Ontario, Canada K1H 8L6.
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149
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Fu TY, Wang JS, Tseng HH. Primary appendiceal lymphoma presenting as perforated acute appendicitis. J Chin Med Assoc 2004; 67:629-32. [PMID: 15779487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Acute perforated appendicitis is a very rare initial presentation of appendiceal lymphoma. A case of primary lymphoma of the appendix in a 42-year-old female is reported here. The symptom was pain in the right lower quadrant of the abdomen. Surgical intervention was performed under clinical diagnosis of acute appendicitis. Grossly, the resected appendix was gangrenous and perforated. Light microscopy revealed transmural infiltration by diffuse large B-cell lymphoma with angioinvasion and tumor necrosis, resulting in perforated acute suppurative appendicitis. To the best of our knowledge, only 4 cases of well-documented primary diffuse large B-cell lymphoma of appendix have been reported in the world literature.
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MESH Headings
- Acute Disease
- Adult
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Appendiceal Neoplasms/complications
- Appendiceal Neoplasms/drug therapy
- Appendiceal Neoplasms/pathology
- Appendicitis/etiology
- Appendicitis/surgery
- Chemotherapy, Adjuvant
- Cyclophosphamide/administration & dosage
- Doxorubicin/administration & dosage
- Female
- Humans
- Lymphoma, B-Cell/complications
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/pathology
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/pathology
- Prednisolone/administration & dosage
- Vincristine/administration & dosage
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Affiliation(s)
- Ting-Ying Fu
- Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
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150
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Pitiakoudis M, Tsaroucha AK, Mimidis K, Polychronidis A, Minopoulos G, Simopoulos C. Mucocele of the appendix: a report of five cases. Tech Coloproctol 2004; 8:109-12. [PMID: 15309649 DOI: 10.1007/s10151-004-0067-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2003] [Accepted: 08/20/2003] [Indexed: 10/26/2022]
Abstract
Mucocele of the appendix is an uncommon disorder, characterized by a cystic dilatation of the lumen. It is often diagnosed clinically from signs and symptoms of acute appendicitis or, if it is asymptomatic, as an incidental finding during ultrasonography, computed tomography, and radiographic examinations of the gastrointestinal tract, or laparotomy. The incidence of mucocele ranges from 0.2% to 0.3% of all appendectomy specimens. We report five cases of appendiceal mucocele (all women, aged 19-90 years), who were admitted from January 1993 to January 2003 to our hospital. These cases represent 0.29% of the 1720 appendectomies performed during this period. Three of the patients were symptomatic and had appendectomies. The final diagnosis for mucocele was given at laparotomy. No colon neoplasms were identified during surgery, and subsequent colonoscopic examinations were also negative. The other two patients were asymptomatic of appendiceal tumor. Colonoscopy revealed two colonic malignant tumors in one patient and an adenocarcinoma of the sigmoid colon in the other. Mucocele of the appendix was diagnosed pre-operatively by ultrasound and computed tomography. One of the two patients underwent a right hemicolectomy and sigmoidectomy; the other one underwent an appendectomy, cecostomy and sigmoidectomy. Four of the patients recovered and are doing well today; one patient died on the twenty-fifth postoperative day. The most common symptom of mucocele is abdominal pain, although many patients may be asymptomatic. Mucocele is often associated with concomitant colon cancer, thus patients with this tumor should be systematically checked for other colonic lesions.
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Affiliation(s)
- M Pitiakoudis
- 2nd Department of Surgery, Medical School Democritus University of Thrace, 6 Ioakeim Kaviri Street, 68100 Alexandroupolis, Greece.
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