A Case of Incidentally Discovered Appendiceal Mucinous Neopl
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A 66‐year‐old Caucasian woman presented to an outside hospital for mild weight loss and fatigue. The patient denied abdominal pain or other symptoms. She underwent a noncontrast CT of the abdomen and pelvis, which revealed an appendiceal mass. She subsequently underwent abdominal ultrasound, which displayed a complex cystic mass suspicious for AM.

Laparotomy revealed a distended appendix (8 × 4 cm), which was consistent with the clinical diagnosis of an AM. The mucin‐filled appendix was grossly intact. Subsequently, an ileocecectomy with ileocolic anastomosis was performed. The patient's postoperative course was uneventful, and she was subsequently discharged and symptom‐free at outpatient follow‐up.

The appendix (9 × 4.2 cm) was opened distally to reveal abundant mucinous material. The appendiceal mesentery showed multiple, pink‐tan lymph nodes without disease involvement (largest at 0.7 cm in greatest dimension). Histological examination showed a low‐grade appendiceal mucinous neoplasm (LAMN) diffusely involving the appendix.

A Brief:
1. Appendiceal mucoceles are misdiagnosed in half of all cases, often as acute appendicitis, a retroperitoneal tumor, or adnexal mass when discovered on radiology, endoscopy, or in the operating room.
2. Contrast‐enhanced CT imaging is most commonly used modality for preoperative diagnosis. CT findings suggestive of a mucocele include an appendiceal lumen >1.3 cm, with cystic dilation, and wall calcification.
3. At present, there is debate concerning the use of laparoscopic versus open resection, with current literature deliberating the advantages and disadvantages of both approaches. Most literature suggests a low incidence of malignant mucinous cystadenocarcinoma.

Source: https://onlinelibrary.wiley.com/doi/full/10.1002/ccr3.694
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