Abstract
A case of appendiceal mucocele with elevated SEAI evel in the cystic fluid detected by colonoscopic examination is presented. A 70-year-old woman was admitted to our hospital because of apositive fecal occult test. Colonoscopy revealed a semispherical, smooth-surfaced, soft elevated lesion at the end of the cecum with a wide circumferential zonal fold, and the orifice of the appendix was undetected, which was strongly suggestive of appendiceal mucocele. Barium enema showed an elevated lesion similar to a submucosal tumor at the lower end of the cecum and a shape of the tumor varied according to pesition and compression, and the appendix was not visualized. Abdominal ultrasonography and CT examination showed a bi-lobular cystic lesion at the ileo-cecal region. Under a diagnosis of appendiceal mococele, operation was performed. Pathological examination showed mutinous cystadenoma, and immunohistochemical staining with antibody to CEA showed positive in part of the cystic wall. CEA level in the cystic fluid was elvated, and after aperatian the serum SEA has smoothly fallen to normal leve1, so CEA was thought to beproduced at the appendiceal mucosa and to be entered into venous system. Number of eases of asyrnptomatie appendieeal mueoeele is thought to increase as number of colonoscopic examination increase. Therfore we should keep appendiceal mucocele in mind when an elevated lesion at the cecum with a wide circumferential zonal fold is found at the end of the cecum.
