Mucinous neoplasia of the cecal appendix

Authors

Keywords:

appendix, neoplasia, mucin.

Abstract

Introduction: Mucinous neoplasms of the cecal appendix are infrequent. These lesions can be an incidental finding in emergency appendectomies, since their preoperative diagnosis is difficult due to the lack of specificity of their symptoms.
Objective: To present a case of low-grade mucinous neoplasia of the cecal appendix.
Case Report: A 73-year-old male patient presented with acute abdominal pain, vital signs and laboratory tests within normal limits, and ultrasonography showing a cecal appendix measuring 76 x 67 x 107 mm. Radical appendectomy was performed, which included resection of the mesoappendix from the appendicular artery, the antimesenteric border of the ligament of Tréves and the free appendicular base, which included the cecum (cecectomy). In the histopathological examination it was observed that the cecal appendix belonged to 10 x 8 x 5 cm with tumor lesion in the base and part of the body; the cut showed outflow of viscous, mucoid, yellowish material, cystic areas of less than 1 cm, congestive vessels, presence of mucous glands with cells showing scarce atypia and an expansive invasion affecting the muscular and mucosal layer with focal loss and slight fibrosis of the submucosa. Low grade cecal appendiceal mucinous neoplasia of the appendix was diagnosed, with resolution and satisfactory evolution of the patient.
Conclusions: Mucinous neoplasms of the cecal appendix may be an incidental finding. They have non-specific symptoms, are largely treated by resection and histopathological study is necessary for their diagnosis.

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Author Biographies

Yinett Hernández León, INOR

Departamento de Anatomía patológica

Julio Jesús Jimenez Galainena, INOR

Departamento Anatomía Patológica

Osyari Ipsan Muñoz, Hospital Dr. Carlos J Finlay

Jefe servicios Quirúrgicos

Liuba Luisa Arteche Hidalgo, Universidad de Ciencias Médicas de las FAR

Médico especialista de Segundo Grado en MGI.

Máster en Salud Ambiental y en Educación Médica.

Investigadora Auxiliar. Profesora Titular. Departamento de formación académica

Lina Isabel Rodríguez Hernández, ISCMH

ISCMH

References

1 . León Díaz AM, Camelo Prado G, Sanabria Lozano DF, Beltrán Tirado MA. Adenocarcinoma de apéndice, un diagnóstico diferencial en pacientes con dolor abdominal. Reporte de un caso. MedUNAB. 2022; 25(1):52-8. DOI: 10.29375/01237 047.4102

2. Guerrero Macías S, Briceño Morales C, González F, Puerto AP, Burgos R, Millán Matta C, et al. Neoplasias apendiculares incidentales. Rev Colomb. 2022 [acceso: 23/01/2023]; 37(2):298-304. Disponible en: https://www.revistacirugia.org/ index.php/cirugia/article/view/1686/1759

3. Notu OA, Jiménez Romero LC, Marcacuzco Quinto AA, Manrique Municio A, Alonso Lago J, Calvo Pulido J, et al. Tumores mucinosos del apéndice: incidencia, diagnóstico y tratamiento quirúrgico. Cir Esp. 2017 [acceso: 02/02/2023]; 95(6): 317-21. Disponible en: https://www.elsevier .es/es-revista-cirugia-espanola-36-pdf-S0009739X17301380

4. Piñón García K, Almeida Esquivel Y, Correa Borrell M. Adenocarcinoma mucinoso diagnosticado enpostapendicectomía bajo anestesia general orotraquial. Revista electrónica Dr Zoilo E. Marinello Vidaurreta. 2021 [acceso: 02/02/2023];46(3): [aprox. 4 pant.]. Disponible en https://revzoilomarinello. sld.cu/index.php/zmv/article/viau/2234

5. Holowatyj AN, Washington MK, Tavtigian SV, Eng C, Horton C. Inherited Cancer Susceptibility Gene Sequence Variations Among Patients With Appendix Cancer. JAMA Oncol. 2022;9(1):95-101. DOI: 10.1001/jamaoncol.2022. 5425

6. Yanai Y, Saito T, Hayashi T, Akasawa Y, Yatagai N, Tsuyama S, et al. Molecular and clinicopathological factures of appendicial mucinous neoplasms. Virchows Archive: An International Journal of Pathology. 2021; 478(3):413-26. DOI: 10.1007/s00428-020-02906-5

7. Carrigo A N, Beagiala D A, Roncoroni V, Orta R, Borretto JJ. Neoplasia mucinosa apendicular. Rev. Argent. Cir. 2021 [acceso: 02/02/2023];113(2):235-42. Disponible en: https://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S2250-639202100020023 5&Ing=es

8. Wong M, Barrows B, Gangi A, Kim S, Mertens RB, Dhall D. Low-Grade Appendiceal Mucinous Neoplasms: A Single Institution Experience of 64 Cases With Clinical Follow-up and Correlation With the Current (Eighth Edition) AJCC Staging. Int J Surg Pathol. 2020 [acceso: 02/02/2023];28(3):252-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31645160/

9. Madriaga Chavarria SE, Hernández Mejía NR, Mesa Siem YC. Adenoma mucinoso apendicular. Reporte de un caso y revisión de la literatura. Rev Ocronos. 2022 [acceso: 02/02/2023];5(9):101. Disponible en: https://revistamedica.com/adenoma-mucinoso-apendicular-reporte-caso/amp/

10. Yildirim E, Kegin M, Özdemir M, Bektas S, Pelen Z, Er M. Neoplasms of the appendix: Single institution and ten-year experiences results. Ulus Travma Acil Cerrahi Derg. 2022 [acceso: 02/02/2023];28(3):352-60.Disponible en: https://pubmed.ncbi.nlm.nih.gov/3548 5573/

11. Anisa Nutu O, Marcacuzco Quinto AA, Manrique Municio, Iago Alonso J, Calvo Pulido J, García Conde M, et al. Tumores mucinosos del apéndice: incidencia, diagnóstico y tratamiento quirúrgico. CIR ESP. 2017 [acceso: 02/12/2023]; 95(6):321-327. Disponible en: https://www.elsevier.es /es-revista-cirugia-espanola-36-pdf-S0009739X17301380

12. Contreras Gala KL, Guzmán Velarde P. Adenocarcinoma mucinoso de apéndice cecal: caso clínico. Rev. Fac. Med. Hum. 2022 [acceso: 27/01/2023]; 22(3):631-6. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S2308-05312022000300631&lng=es

13. Ahadi M, Sokolova A, Brown I, Chou A, Gill AJ. The 2019 World Health Organization Classification of appendiceal, colorectal and anal canal tumours: an update and critical assessment. Pathology. 2021 [acceso: 02/02/2023];53(4):454-61. Disponible en: https://www.sciencedirect.com/ science/article/abs/pii/S0031302520 310205

14. Kang DW, Kim BH, Kim JM, Kim J, Chang HJ, Chang MS, et al. Gastrointestinal pathology Study Group of the Korean Society of Pathologist. Standardization of pathologic diagnosis of appendicial mucinous neoplasms. J Pathol Transl Med. 2021 [acceso: 02/11/2023];55(4):247-64. Disponible en: https://www.jpatholtm.org/upload/pdf/jptm-2021-05-28.pdf

15. González Bayón L, Martín Román L, Lominchar PL. Appendiceal Mucinous Neoplasms: From Clinic to Pathology and Prognosis. Cancers (Basel). 2023 [acceso: 02/11/2023];15(13):3426. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10340652/

16. González-Moreno S, Sugarbaker PH. Radical appendectomy as an alternative to right colon resection in patients with epithelial appendiceal neoplasms. Surg Oncol. 2017 [acceso: 02/11/2023]; 26:86-90. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0960740416301190

Published

2024-04-15

How to Cite

1.
Hernández León Y, Jimenez Galainena JJ, Ipsan Muñoz O, Arteche Hidalgo LL, Rodríguez Hernández LI. Mucinous neoplasia of the cecal appendix. Rev Cubana Med Milit [Internet]. 2024 Apr. 15 [cited 2025 Apr. 3];53(2):e024033631. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/33631

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Section

Case Presentation