# Low Grade Appendiceal Mucinous Neoplasm – A Case Series A Silent Threat with Deadly Consequences

## TL;DR

This case series explores low-grade appendiceal mucinous neoplasms and their deadly complication pseudomyxoma peritonei, emphasizing the importance of diagnosis and staging.

## Contribution

The study presents five distinct cases with varied clinical courses and highlights the need for a unified diagnostic approach for appendiceal mucinous neoplasms.

## Key findings

- Pseudomyxoma peritonei is a serious complication of ruptured appendiceal tumors.
- Immunohistochemistry confirmed tumor origin in cases involving both appendix and ovary.
- Grading and staging are critical for prognosis and management of these neoplasms.

## Abstract

Our study was mainly aimed at identifying the cause, clinical course of the disease, its most dreaded complication pseudomyxoma peritonei and spread to adjacent structures. We have used IHC techniques to know the origin of the tumor where both appendix and ovary were involved.

We have listed out and discussed in detail 5 cases, each of which have a different clinical course and variation in staging, grading and prognosis. One of the cases had mucin deposit in the ovary for which IHC was done to confirm the origin of the tumor. Some of the findings were incidental and in others presence of mucin content in the appendix lumen raised clinical suspicion of spread to peritoneum and adjacent structures. Grading and staging is of prime importance as it determines the prognosis and management of the patient respectively.

A ruptured or perforated appendix must warrant for an immediate suspicion of pseudomyxoma peritonei which when untreated can lead to mucinous neoplasms in adjacent organs like ovary and colon. Pseudomyxoma Peritonei (PMP) with simultaneous appendix and ovarian neoplasm should be treated as primary appendiceal tumour. Grading and staging of mucinous neoplasm of appendix and Pseudomyxoma Peritoneii needs a unified approach for standardized diagnostic reporting.