Appendiceal mucocele of mucinous cystadenocarcinoma with a cutaneous fistula.
We report a novel case of cystadenocarcinoma forming an appendiceal mucocele with development of a skin fistula. The patient was a 75-year-old Japanese woman who originally presented with a skin ulcer on the right flank (inferior to the ribs and superior to the iliac bone) with mucus discharge. The serum concentration of carcinoembryonal antigen was elevated (57.4 ng/ml). Ultrasonography and computed tomography demonstrated a cystic mass with septations in the right iliac fossa. Fistulography from the skin ulceration showed a communication via the fistula to the caecum. A right hemicolectomy and enbloc resection of the skin fistula was performed. The histological findings revealed a well-differentiated mucinous cystadenocarcinoma of the appendix. The patient has been alive for 7 years following surgery without any sign of recurrence. This report is of interest as it demonstrates that tumour rupture to the extraperitoneal space could result in a good outcome by preventing the development of pseudomyxoma peritonei.
Nakao
A
A
First Department of Surgery, Okayama University Medical School, 2-5-1 Shikatacho, Okayama, Okayama 700-8558, Japan. anakao@imap.pitt.edu
Sato
S
S
Nakashima
A
A
Nabeyama
A
A
Tanaka
N
N
D000368:Aged; D001063:Appendiceal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D001065:Appendix / Q000473:pathology*; D017577:Cutaneous Fistula / Q000209:etiology* / Q000473:pathology; D018282:Cystadenocarcinoma, Mucinous / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D009078:Mucocele / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D011553:Pseudomyxoma Peritonei / Q000517:prevention & control