RESUMEN
BACKGROUND: Mucocele is a cystic dilatation of the vermiform appendix that contains mucous material. It may be caused by benign or malignant diseases. AIM: To report and discuss four cases with mucocele. REPORT OF CASES: The main clinical manifestations were abdominal pain and changes in the bowel habits. In two cases, appendiceal mucocele was an incidental finding in the diagnostic work-up or operation for acute diverticulitis and acute cholecystitis, respectively. The diagnostic approach included barium enema and CT scan of the abdomen. In three cases, the mucocele was secondary to mucinous cystadenoma; two of them had a preoperative diagnosis of mucocele and underwent colonic preparation and right hemicolectomy, one patient underwent appendectomy alone. The remaining case underwent appendectomy alone, was found to have mucinous adenocarcinoma, and underwent a right hemicolectomy in a second operation. Postoperative outcome was adequate in all cases. CONCLUSION: Mucocele of the vermiform appendix is a rare disease. An appendectomy is an adequate treatment for benign disease. If malignant disease is demonstrated, a right hemicolectomy should be performed.
Asunto(s)
Apéndice , Mucocele , Adulto , Anciano , Anciano de 80 o más Años , Apendicectomía , Neoplasias del Apéndice/complicaciones , Neoplasias del Apéndice/diagnóstico , Neoplasias del Apéndice/cirugía , Enfermedades del Ciego/diagnóstico , Enfermedades del Ciego/etiología , Enfermedades del Ciego/cirugía , Colectomía , Cistoadenoma Mucinoso/complicaciones , Cistoadenoma Mucinoso/diagnóstico , Cistoadenoma Mucinoso/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mucocele/diagnóstico , Mucocele/etiología , Mucocele/cirugía , Tomografía Computarizada por Rayos XRESUMEN
We describe a case of mucinous cystadenoma of the appendix with perityphlic granuloma. The patient developed a hard palpable mass in the right lower quadrant and barium enema induced irregular bowel wall at the cecum. Based on a preoperative diagnosis of carcinoma of the appendix, we performed a laparotomy. On operation, we found a tumor mass in the region of the appendix; the mass adhered strongly to the retroperitoneum and cecum. Right hemicolectomy was carried out on a diagnosis of carcinoma of the appendix. Microscopic examination revealed mucinous cystadenoma of the appendix with perityphlic granuloma. Mucinous cystadenoma in the appendix is a rare tumor. In this patient, the tumor was accompanied by granuloma formation in adjacent tissues because of mucin expelled from the appendix. This case emphasizes that granuloma formation can make of difficult to differentiate mucinous cystadenoma in the appendix from cancer.
Asunto(s)
Neoplasias del Apéndice/complicaciones , Apéndice/patología , Cistoadenoma Mucinoso/complicaciones , Granuloma/complicaciones , Neoplasias del Apéndice/diagnóstico , Neoplasias del Apéndice/cirugía , Enfermedades del Ciego/complicaciones , Enfermedades del Ciego/diagnóstico , Enfermedades del Ciego/cirugía , Ciego/patología , Cistoadenoma Mucinoso/diagnóstico , Cistoadenoma Mucinoso/cirugía , Diagnóstico Diferencial , Femenino , Granuloma/diagnóstico , Granuloma/cirugía , Humanos , Persona de Mediana Edad , Mucocele/diagnósticoRESUMEN
Women diagnosed with early stage ovarian cancer may be considered for adjuvant therapy. Intraperitoneal chromic phosphate (P-32) is commonly used in these patients with few complications. A woman found to have early stage ovarian cancer was given intraperitoneal P-32 in the presence of a lingering pelvic infection, which is usually not mentioned as a contraindication to its use. Radiation damage to the small bowel and cecum developed as did damage to the ureter and bladder, which then required surgery.