Large Mucocele of the Appendix Discovered in a 48-Year-Old Male Presenting With Appendicitis: A Case Report

Dimitar I. Semerdzhiev, Arkansas College of Osteopathic Medicine
Robert E. Hardister, Unity Health
Stephen D. Wagner, Unity Health
Dewey R. McAfee, Unity Health
David Martin, Unity Health
Suporn Sukpraprut-Braaten, Kansas City University

Abstract

The appendix is a vermiform-like organ that extends from the cecum and has been thought of as having a rudimentary immunologic function. However, the appendix can become distended and mucus-filled, classifying it as a mucocele appendix. Mucoceles can be found in various locations in the body, including the colon and the appendix, and have malignancy potential.

We report a case of a 48-year-old male that presented to the ED with a history of two days of abdominal pain. Upon arriving at the ED, he had a CT scan showing a 9.5 x 4.2 x 6.4 cm fluid collection in the right lower quadrant (RLQ) juxtaposed to the cecum, suggesting appendicitis or an abscess. Initially, a laparoscopic approach was taken, which was then converted to an open laparotomy. The mass was excised and a right hemicolectomy was performed along with an ileocolonic anastomosis due to extensive involvement of the large intestine. Pathology reported a low-grade appendiceal mucinous neoplasm resected with negative margins and 16 negative lymph nodes.