Incidental Discovery and Removal of an Appendiceal Mucocele in a Patient With Acute Cholecystitis

TL;DR

A rare case where a patient with gallbladder inflammation had an unexpected appendix tumor and liver lesion discovered and treated during surgery.

Contribution

Reports a rare incidental finding and successful surgical management of an appendiceal mucocele during cholecystectomy.

Findings

Appendiceal mucocele and hepatic lesion were identified during CT for acute cholecystitis.

Surgical excision confirmed benign appendiceal mucocele and hemangioma in the liver.

Highlights the importance of removing appendiceal mucoceles to prevent life-threatening complications.

Abstract

Appendiceal mucoceles (AMs) are a rare clinical entity among appendiceal tumors. They are characterized by dilation of the appendix and accumulation of mucus within the lumen. These lesions are often discovered incidentally during imaging or surgery for unrelated abdominal complaints. We report a case of a 55-year-old male who presented with right upper quadrant pain due to acute cholecystitis. An AM and a hepatic lesion were incidentally identified on abdominal CT. The patient underwent a robotic-assisted laparoscopic cholecystectomy and appendectomy, with pathology confirming a benign AM and acute cholecystitis. A coincidental hepatic lesion was also biopsied and diagnosed as a hemangioma. Although rare and usually benign, AMs have the potential to rupture and cause the potentially fatal condition pseudomyxoma peritonei. They may also become malignant, act as lead points for intussusception, or cause bowel obstruction due to mass effect. This case highlights the importance of a comprehensive abdominal evaluation and demonstrates the value of prompt surgical excision of AMs to prevent complications.

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