Abstract
The patient was a man in his seventies who was seen at our hospital because of left lower quadrant abdominal pain. Abdominal echography revealed a tumor at the median of the lower abdomen. Abdominal CT scan showed a 90-mm diameter cystic tumor continuing to the tip of the appendix. Blood analysis showed an increased CEA level, 28.9ng/dl. Mucocele of the appendix was likely and laparotomy was performed. During surgery, a fist-sized tumor was present above the bladder, and from a part of which mucus leakage was identified. Since the tumor firmly adhered to the sigmoid colon and was likely to have invaded it, mucinous cystadenocarcinoma of the appendix was suspected. We performed a removal of the tumor, together with ileocecal resection, D3 dissection, and partial sigmoidectomy. Histopathologically the tumor was diagnosed as mucocele of the appendix and the adhesions to the sigmoid colon were clarified to be inflammatory adhesions caused by leaked mucus. The postoperative course was uneventful and the CEA level was normalized to 4.8ng/dl.
In the past 30 years, only five cases of benign mucocele of the appendix which was associated with adhesions to other organs and required associated resections have been reported in Japan. This case is considered to have followed a rare course and then we present the case together with a review of the literature.
