Learning objectives
The appendiceal mucinous neoplasm (AMN) is a rare entity whose incidence and importance are increasing.
The objectives of this work are:
To clarify and define the terminology of AMN,
peritoneal pseudomyxoma (PMP) and mucocoele (or mucocele) since there is great confusion in the literature.
To illustrate the relationship between AMN,
peritoneal pseudomyxoma (PMP) and mucocoele.
To describe the various presentations of those entities.
To explain the relevance of the radiological assessment regarding the treatment and therefore the prognosis.
Background
DEFINITIONS AND HISTOLOGY
APPENDICEAL MUCINOUS NEOPLASM
The terms appendiceal mucinous neoplasm and peritoneal pseudomyxoma have been in permanent discussion and their classification has been controversial,
creating confusion in the scientific literature.
Fortunately,
pathologists,
oncologists and surgeons reached a consensus in the Peritoneal Surface Oncology Group International (PSOGI) World Congress in Berlin in 2012 [1].
Appendiceal mucinous neoplasms (AMN) belong to the group of epithelial neoplasms of the appendixrefered in Fig. 2 [2]
The focus of the presentation will be set on the appendiceal neoplasms that...
Findings and procedure details
SIGNS AND SYMPTOMS
The symptoms of the AMN are given by its presentation,
the most frequent form being the mucocoele.
The most constant symptom of mucocoele is abdominal pain and symptoms of appendicitis.
Other symptoms are a palpable mass in the right iliac fossa and obstruction,
and the mucocoele can act as lead point of an intussusception.
The symptoms of a benign or neoplastic cause of mucocoele cannot be distinguished [5].
Many patients are asymptomatic,
and it is an incidental diagnosis [11].
The serum elevation...
Conclusion
The AMN is a special entity because its prognosis is not only determined by the grade of the primary lesion (often without infiltrative invasion capacity) but more importantly by the presence of PMP.
AMN is the most common cause of mucocoele and it is often encountered with secondary ovarian involvement.
We should be alert to the signs pointing at a neoplastic cause of mucocoele or the presence of PMP to provide an accurate diagnosis in order to contribute to the optimal surgical management and therefore...
References
[1]
Y.
Li,
«Highlights from the 8th World Congress on Peritoneal Surface Malignancies,» Cancer Biol.
Med, pp.
277-278,
2012.
[2]
N.
Carr,
R.
Bibeau y R.
Bradley,
«The histopathological classification,
diagnosis and differential diagnosis of mucinous appendiceal neoplasms,
appendiceal adenocarcinomas and pseudomyxoma peritonei.,» Histopathology, pp.
847-858,
2017.
[3]
N.
Carr,
T.
Cecil,
F.
Mohamed y L.
Sobin,
«A Consensus for Classification and Pathologic Reporting of Pseudomyxoma Peritonei and Associated Appendiceal Neoplasia: The Results of the Peritoneal Surface Oncology Group International (PSOGI) Modified Delphi Process.,» Am...