Mucocele of the appendix presenting as an adnexal mass

✍ Scribed by Jinan O. Bahia; Melanie H. Wilson

• Publisher: John Wiley and Sons
• Year: 1989
• Tongue: English
• Weight: 389 KB
• Volume: 17
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/jcu.1870170114

✦ Synopsis

Mucocele of the appendix is uncommon and rarely diagnosed preoperatively . Accurate diagnosis is important since some of these lesions are malignant. Another serious complication is rupture resulting in pseudomyxoma peritonei. In this article, we describe the sonographic findings in a woman with mucocele of the appendix presenting as a right adnexal mass. The sonographic appearance is compared with that in other cases reported in the literature.

CASE REPORT

A 46-year-old female, gravida 2, para 2002, was found to have an irregular, tender right adnexal mass on routine annual pelvic examination. Abdominal sonography revealed a large, 11.5 cm x 4 cm, elongated bilobed cystic mass in the right adnexal region (Figures 1A and1B). The mass had internal echoes and demonstrated enhanced through-transmission. The possibility of hydroor pyosalpinx, tubo-ovarian abscess, or cystic ovarian mass was raised.

A barium enema examination demonstrated filling of a small portion of the appendix (Figure 2). There was no mass effect on the cecum and no abnormal calcifications were seen. The patient underwent exploratory laparotomy for possible right salpingo-oophorectomy.

At surgery, the uterus and ovaries were normal. A tubular, 12 cm x 4 cm mass was found to involve almost the entire appendix. There was 1 cm of normal appendix at its origin from the cecum. Appendectomy was performed. Examination of the surgical specimen (Figures 3A and3B) revealed a smooth walled cyst filled with thick yellowish mucous. There was a ridge-like From the