Low-Grade Appendiceal Mucinous Neoplasm Adhered to the Posterior Cecum: A Case Report

TL;DR

This case report describes a rare appendiceal tumor in a 72-year-old woman with unusual symptoms and imaging findings, requiring a right hemicolectomy.

Contribution

The paper highlights a rare case of LAMN with atypical presentation and imaging discrepancies, emphasizing diagnostic and surgical challenges.

Findings

The patient presented with bloating and constipation, not typical acute appendicitis symptoms.

Imaging showed discrepancies between CT and MR, complicating diagnosis.

A posteriorly positioned mucocele adhered to the cecum was found, requiring right hemicolectomy.

Abstract

Low-grade appendiceal mucinous neoplasms (LAMN) constitute a rare subset of epithelial tumors and represent the second most common form of appendiceal cancer. LAMN typically presents as acute appendicitis, with definitive diagnosis often occurring incidentally during appendectomy surgery. While contrast-enhanced computed tomography (CECT) is the imaging of choice, misdiagnoses are common, highlighting the need for additional diagnostic modalities that are often underutilized. There is ongoing debate about treatment recommendations which typically involve a simple appendectomy, but controversy persists regarding the intraoperative necessity of a cecectomy, ileocecectomy, or formal right hemicolectomy. Here, we present a case featuring a 72-year-old African American female referred to our surgery clinic presenting solely with bloating and constipation rather than classical acute appendicitis, discrepancies between CT and MR imaging, and an unusual intraoperative finding of a posteriorly positioned mucocele adhered to the cecum, necessitating right hemicolectomy.

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