High-Grade Appendicular Mucinous Neoplasia (jelly belly): A Rare Case Report

Abstract

Introduction: Primary neoplasms of the appendix are present in less than 2% of surgical appendectomy specimens. The major categories of primary neoplasms include epithelial tumors, mesenchymal tumors and lymphomas. Mucinous neoplasms of the appendix are a complex, diverse group of epithelial neoplasms often causing cystic dilation of the appendix due to accumulation of gelatinous material, morphologically referred to as mucoceles. A case of High grade Mucinous Neoplasia of appendix with Pseudomyxoma peritonei is presented with a discussion of the histologic and radiologic features as well as the surgical management.
Material and Methods: This is a case report of Patient with Appendicular mucinous neoplasia with pseudomyxoma peritonei diagnosed in an elderly with it’s surgical management.
Discussion: Appendiceal mucinous neoplasms are a heterogeneous group of neoplasms ranging from simple mucoceles to complex pseudomyxoma peritonei. Mucoceles are subset that consists of gradual cystic dilation of the vermiform appendix due to slow accumulation of mucoid contents. It is uncommonly seen, occurring in between 0.2% and 0.4% of appendectomies and 0.3 %and 0.7% of all appendiceal pathology. The classification of mucinous neoplasms of the appendix is controversial and different terminologies have been used to describe these lesions. Recent efforts to build a consensus naming system have led to the development of a classification system that includes LAMN, HAMN, and mucinous adenocarcinomas.
Conclusion: In conclusion, Classification and taxonomy of mucinous neoplasms is complex and controversial. Distribution of mucin and the presence of nodal and visceral metastases beyond the peritoneum help to differentiate low-grade and high-grade PMPs. PMP with simultaneous appendix and ovarian neoplasm should be treated as a primary appendiceal tumor. Clear communication between the radiologist, pathologist and surgeon is important for optimal patient manageme.