Keywords:
Abdominal Viscera, Abdomen, Gastrointestinal tract, CT, Biopsy, Surgery, Inflammation, Neoplasia, Pathology, Retrospective, Cross-sectional study, Performed at one institution
Authors:
K. Khandwala1, N. Sajjad2, W. A. Memon1, A. Malik3; 1Karachi/PK, 2Karachi, Si/PK, 3Atlanta/US
DOI:
10.26044/ecr2020/C-04208
Purpose
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 be incidentally discovered on imaging or during surgery or can clinically present with right lower quadrant pain and/or a palpable mass [5].
A mucocele can also become inflamed, and the clinical and radiological findings can mimic those of acute appendicitis [6]. It is imperative to identify mucoceles preoperatively because of the risk of pseudomyxoma peritonei in case of inadvertent rupture during surgery. Therefore, the surgical approach needs to be tailored to prevent such complications. Additionally, more extensive surgical resection/frozen section biopsy may be required if a neoplastic cause of a mucocele is discovered [7]. The causes of mucocele formation are sometimes tricky to identify on cross-sectional computed tomography (CT). Therefore, the main objective of this study will be to try to identify the CT features of mucocele of the appendix and correlate the imaging findings with histopathological diagnosis in inflammatory, benign and malignant lesions and whether these entities can be accurately differentiated on CT imaging.