title: Appendiceal mucinous neoplasms: an uncertain nosological entity. Report of a case.
abstract: BACKGROUND
  Appendiceal mucocele is a relatively rare condition characterized by progressive dilation of the appendix caused by intraluminal accumulation of mucoid substance. Its incidence is 0.07 - 0,63% of all appendectomies performed.
  
  
  METHODS
  We report the case of a 70-year-old man who came to our observation with gravative pain in right lower abdominal region. A computed tomography abdominal scan revealed a cystic/tubular structure like an appendicular mass with wall enhancement but without calcifications suggestive of a mucocele. Into peritoneal cavity we found profuse mucinous material with a 1,5 cm size parietal nodule. We also identified a free perforation of the cecum with consensual spillage of gelatinous material mimicking a pseudomyxoma peritonei. We decided to perform a right hemicolectomy with excision of peritoneal lesion.
  
  
  CONCLUSIONS
  The controversy in the pathologic terminology can give rise to a clinical dilemma in terms of the management and follow-up plans. For mucosal hyperplasia and cystadenoma simple appendectomy is curative. Only in case of large base of implantation it may be necessary the resection of the ileum and caecum or right hemicolectomy. In case of mucinous cystoadenocarcinoma authors perform a right hemicolectomy.
  
  
  CONCLUSIONS
  Appendiceal mucinous neoplasms are different pathological entities. The correct surgical management depends on size and location of lesion. A preoperative diagnosis is obviously needed in order to perform the correct treatment. CT abdominal scan is the better diagnostic tool, but different authors show their inability to reach a preoperative diagnosis in the larger majority of cases.
authors.forename: A
authors.initials: A
authors.lastname: Agrusa
authors.forename: G
authors.initials: G
authors.lastname: Romano
authors.forename: M
authors.initials: M
authors.lastname: Galia
authors.forename: G
authors.initials: G
authors.lastname: Cucinella
authors.forename: V
authors.initials: V
authors.lastname: Sorce
authors.forename: G
authors.initials: G
authors.lastname: Di Buono
authors.forename: F
authors.initials: F
authors.lastname: Agnello
authors.forename: G
authors.initials: G
authors.lastname: Amato
authors.forename: G
authors.initials: G
authors.lastname: Gulotta
mesh_terms: D000368:Aged; D001062:Appendectomy / Q000379:methods; D001063:Appendiceal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D002430:Cecal Neoplasms / Q000601:surgery; D003082:Colectomy / Q000379:methods; D018291:Cystadenoma, Mucinous / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D008297:Male; D016896:Treatment Outcome