Ileocecal Intussusception Due to Appendiceal Mucinous Neoplasm: A Case of Diagnostic Anticipation and Management Perspective | Chapter 4 | Medicine and Medical Research: New Perspectives Vol. 4

Introduction: The intussusception is a rare cause of intestinal occlusion in adults (1-5%). Usually, they are secondary to an underlying pathology, generally identified intraoperatively. Mucinous appendiceal neoplasm occurs in less than 1% of appendicectomies. This work aims to present an unusual case and our therapeutic approach.

 

Presentation of Case: A 54-year-old female patient came to the emergency department with abdominal pain. Complementary diagnostic exams showed an image of ileocolic invagination due to an appendicular mass, confirmed intraoperatively.  A right hemicolectomy was performed for oncological purposes. The anatomopathological study revealed a low-grade appendicular mucinous neoplasm.

 

Discussion and Conclusion:  The treatment of ileocolic invagination is surgical, due to the high incidence of a malignant etiology. In this particular case, there was already a preoperative suspicion of an appendicular neoplasm, which justified proposing a right hemicolectomy. There is no consensus on the post-operative monitoring of Low-Grade Appendiceal Mucinous Neoplasm (LAMN). After 5 years, the patient was asymptomatic, with no signs of recurrence.

 

Author (s) Details

Maria João Vale
Surgery Department, Hospital Sousa Martins, Unidade Local de Saúde da Guarda, Portugal.

 

Pedro Caldes
Surgery Department, Hospital Sousa Martins, Unidade Local de Saúde da Guarda, Portugal.

 

Sónia Bispo
Surgery Department, Hospital Sousa Martins, Unidade Local de Saúde da Guarda, Portugal.

 

Augusto Lourenço
Surgery Department, Hospital Sousa Martins, Unidade Local de Saúde da Guarda, Portugal.

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v4/1956

 

Acellular Appendix Vermiform Mucinous Neoplasm: A Rare Clinical Entity | Chapter 6 | Medical Science: Trends and Innovations Vol. 12

Neoplasms of the appendix are infrequent and either asymptomatic or present with nonspecific symptoms, rendering their diagnosis extremely difficult. In female patients, these tumors are frequently misdiagnosed as gynecologic disorders, particularly when patients complain of right iliac fossa pain. Because of their rarity and absence of distinctive clinical characteristics, appendiceal tumors are not considered in the differential diagnosis by gynecologists during the evaluation of patients with pelvic masses.  This case report describes a 56-year-old female patient with a mass in the right lower pelvis that was initially presumed to be of ovarian nature according to preoperative imaging. Upon exploratory laparotomy, however, the uterus and adnexa were found to be macroscopically normal. The mass was subsequently discovered to be of appendiceal origin growing into the right adnexa's anatomical territory and closely associated with the atrophic right ovary. Appendix was resected intact and histopathology confirmed a tumor made up of acellular mucin. This case emphasizes the difficulty in preoperative diagnosis of appendiceal mucoceles, which are typically incidental radiologic findings and are typically diagnosed only at the time of surgery. The dilemma in diagnosis mandates that gynecologists and surgeons must be more vigilant to consider appendiceal pathology in the context of unexplained right lower quadrant or pelvic masses.

 

Author (s) Details

 

Panagiotis Tsikouras
Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece.

 

Christina Pagaki
Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece.

 

Konstantinos Nikolettos
Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece.

 

Nektaria Kritsotaki

Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece.

 

Sonia Kotanidou
Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece.

Maria Kouroupi
Department of Pathology, Democritus University of Thrace, Greece.

 

Nikolaos Tsikouras
Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece.

 

Aggeliki Gerede
Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece.

 

Nikolaos Machairiotis
Department of Obstetrics and Gynecology, Attikon Hospital Kapodistrian University of Athens, Greece.

 

Nikolaos Nikolettos
Department of Obstetrics and Gynecology, Democritus University of Thrace, Greece.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v12/4932