Appendiceal mucocele: clinical and imaging features of 14 cases.

Abstract

PURPOSE: Appendiceal mucocele as a cystic dilatation filled with mucinous material is a very rare disease of the appendix vermiformis. Its preoperative diagnosis is still acking behind common use of imaging techniques. METHODS: Retrospective analysis of the patients with a pathological diagnosis of appendiceal mucocele with regard to clinical and imaging features. RESULTS: The study group included 14 patients with a mean age of 51 years (range from 17 to 82 years). Predominant symptoms were pain and feeling of fullness in the right iliac fossa in 9(64%) and 5 (36%) patients, respectively. For imaging purposes, use of computed tomography resulted in preoperative diagnosis of appendiceal mucocele in half of the patients(50%). 93% of the cases underwent appendectomy, and righth emicolectomy was performed in one patient (7%). Mucocele and cystadenoma were detected in 11 (79%) and 3 (21%)patients, respectively. Presence of acute appendicitis and coloncarcinoma were confirmed afterwards histologically in 4 (29%)and one (7%) patients, respectively. CONCLUSIONS: Despite the common use of imaging studies,preoperative diagnosis of appendiceal mucocele is still not possible in most of the cases. During surgical treatment,which is tailored according to imaging and intraoperative findings, precautionary measures to avoid intraperitoneal rupture and dissemination should be taken.