Appendiceal mucocele is a relatively uncommon entity that is caused by dilatation of the appendix due to obstruction of the appendiceal lumen by mucoid material [1]. Previously reported incidence of mucoceles is 0.2% to 0.7% of all excised specimens on histopathology and they may be present in 8-10% of appendiceal tumors [2,3]. This condition can have benign as well as malignant processes. There are four histologic types of appendiceal mucocele: retention cyst, mucosal hyperplasia, mucinous cystadenoma, and mucinous cystadenocarcinoma (4). Mucoceles of the appendix can...

This was a retrospective, cross-sectional, single-center study conducted after approval by the ethical review committee. The radiology database of Aga Khan University Hospital, Karachi, Pakistan was searched for patients who had keywords “appendiceal mucocele” in CT reports from January 2009-2019. Only cases with histopathologic examination of the lesions obtained after surgical excision were included. Patients without biopsy results and pediatric patients were excluded from the study. We used either enhanced or unenhanced CT imaging. The patients who underwent contrast-enhanced CT received 1.5 mL/kg iohexol (300...

31 patients were included in the study.10 out of 31 patients presented with diffuse abdominal pain.9 of the 31 patients presented with symptoms of acute appendicitis and localized right iliac fossa pain, while 4 presented with a palpable abdominal mass. 20 patients underwent simple appendectomy while 11 patients underwent right hemicolectomy. The mean appendiceal diameter was 2.6 cm (1.1-5.4 cm), wall thickness was 2.8 mm (1.1-8.8 mm) and mean attenuation was 28 HU (5-173 HU). Periappendiceal fat stranding showed statistically significant association with inflammatory mucoceles...

Differentiating inflammatory, benign and malignant mucoceles can be challenging with CT. Our study shows that soft-tissue thickening and internal septations are features most likely to be associated with malignancy. Mural calcification is more associated with benign mucoceles whereas periappendiceal fat stranding and wall enhancement are usually associated with inflammatory appendiceal mucoceles.

K. Khandwala; Karachi/PK - nothing to disclose N. Sajjad; Karachi/PK - nothing to disclose W. A. Memon; Karachi, SI/PK - nothing to disclose A. Malik; Atlanta/US - nothing to disclose

(1) Demetrashvili Z, Chkhaidze M, Khutsishvili K, et al. Mucocele of the appendix: case report and review of literature. Int Surg. 2012;97(3):266–269. (2) Abuoglu H, Yıldız MK, Kaya B, Odabaşı M. Clinicopathological analysis of patients operated for appendiceal mucocele.Ulus Travma Acil Cerrahi Derg. 2017; 23(3):230-234. (3) Rangarajan M, Palanivelu C, Kavalakat AJ, Parthasarathi R. Laparoscopic appendectomy for mucocele of the appendix. Report 8 cases. Indian J Gastroenterol. 2006;25(5):256–257. (4) Aho A, Heinonen R, Lauren P. Benign and malignant mucocele of the appendix. Acta Chir Scand....