Fact-sheet: Mucocele of appendix
Updated on 10/03/2018 at 8:58 AM
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Definition
Dilatation of the appendix caused by mucus accumulation, which may correspond histologically to simple epithelial hyperplasia, a benign cystadenoma, or a cystadenocarcinoma.
Clinical features
Asymptomatic forms Appendiceal syndrome Right iliac fossa mass
Radiography
Possible peripheral curvilinear calcifications
Ultrasound
Fluid collection with more or less thick content in the right iliac fossa, possibly surrounded by infiltration or effusion.
Possible wall stratification or endoluminal polyp.
Suggestive calcifications.
Posterior enhancement.
CT
Well-defined oval fluid collection attached beneath the cecal pole in place of the appendix.
The presence of a thin wall calcification is highly suggestive of the diagnosis.
Search for a synchronous ovarian, gallbladder, or colorectal tumor.
Search for complications: appendiceal volvulus, intussusception into the cecum, intraperitoneal rupture, gelatinous disease of the peritoneum (pseudomyxoma peritonei).
Search for cystic fibrosis (in children).
Follow-up: screen for metachronous colorectal lesions.
Management
Two-fold problem:
- Malignant transformation (cystadenocarcinoma).
- Risk of intraoperative dissemination if perforation occurs: gelatinous disease of the peritoneum / pseudomyxoma peritonei.
Importance of notifying the surgeon preoperatively