[Appendiceal mucocele misdiagnosed with infected urachal cyst: a differential diagnosis to keep in mind]. / Mucocele apendicular confundido con quiste de uraco infectado: un diagnóstico diferencial a tener en cuenta.

OBJECTIVE: To report one case of appendiceal mucocele misdiagnosed with an infected urachal cyst and to review their differential diagnosis, treatment and prognosis. PATIENT: We report the case of a 74-year-old-male with abdominal pain, fever and dysuria. Hypogastric abscess image in ultrasonography and CT. Percutaneous drainage and antibiotic therapy. Opaque enema, colonoscopy and cystoscopy were normal. RESULTS: Exploratory laparotomy and resection of a large cecum-fixed mass, independent to the bladder. Appendectomy and cecectomy. Pathology showed an appendiceal mucinous cystoadenoma (mucocele). CONCLUSIONS: Appendiceal mucoceles and urachal cysts are uncommon, mostly asymptomatic. Cystoadenoma or cystoadenocarcinoma mucoceles are large and can reach the midline, confounding with urachal cysts. Diagnosis by ultrasonography and/or CT. Surgical treatment in both, keeping the mucocele intact during operation to avoid the risk of pseudomyxoma peritonei.

[Mucocele of the vermiform appendix]. / Mucocele del apéndice vermiforme.

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.

Mucinous cystadenoma of appendix concomitant with perityphlic granuloma.

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.

[Mucus-secreting tumors of the appendix: a preoperative diagnosis is possible. Apropos of 2 cases]. / Tumeurs muco-sécrétantes de l'appendice: un diagnostic pré-opératoire est possible. A propos de deux observations.

The authors present two cases of pseudo tumoral type Mucus Secreting Tumours (MST) of the appendix. In this type (32% of the cases), the clinical presentation, barium enema, ultrasonography and most importantly CT scan generally confirm the preoperative diagnosis. We found three advantages this preoperative diagnosis. 1) Primarily it allow selection of a large surgical approach that permits full exploration of the abdominal cavity especially the ovaries (2-18% associated lesions); 2) also it allows a histopathological examination (frozen section) of the appendix to be performed during the operation; 3) and finally the surgical treatment will depend on the operative findings and the result of the histopathological examination: in the benign forms simple appendicectomy will be sufficient but the malignant forms (12% of the cases) should be treated by right hemicolectomy.