Annals of Coloproctology

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Case Report

Primary Retroperitoneal Mucinous Cystadenoma: Seok Youn Lee, Weon Cheol Han; Ann Coloproctol. 2016;32(1):33-37. Published online February 29, 2016; DOI: https://doi.org/10.3393/ac.2016.32.1.33

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Mucinous cystadenomas and cystadenocarcinomas of the ovary are clinically and histopathologically well-established common tumors. However, primary retroperitoneal mucinous cystic tumors are extremely rare, and although their histopathogenesis is still uncertain, several theories have been proposed. Most authors suggest that they develop through mucinous metaplasia in a preexisting mesothelium-lined cyst. An accurate preoperative diagnosis of these tumors is difficult because no effective diagnostic measures have been established. Delay in diagnosis and treatment of this tumor may be fatal for the patient because of complications such as rupture, infection, and malignant transformation. We describe the case of a 31-year-old woman with abdominal pain and a palpable mass. Computed tomography of the abdomen revealed a retroperitoneal cystic mass, which was resected successfully through laparoscopy. Histopathological examination of the resected mass confirmed the diagnosis of a primary retroperitoneal mucinous cystadenoma. The patient was discharged on postoperative day 5 without any complications.

Citations

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Original Article

Appendiceal Mucocele.: Choi, Young cheol , Jeong, Keuk Won , Lee, Seok , choi, Hyun cheol; J Korean Soc Coloproctol. 1999;15(4):315-320.

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Abstract PDF: PURPOSE
Mucocele of the appendix is merely a descriptive term for abnormal mucus accumulation causing distension of the appendiceal lumen, irrespective of the underlying cause. If untreated, one type of mucocele may rupture producing a potentially fatal entity known as pseudomyxoma peritonei. The purpose of this study is to clarify the clinical pictures of appendiceal mucocele and to provide a guide for treatment.
METHODS
To search the clinical characteristics of appendiceal mucocele, we retrospectively investigated 16 cases of appendiceal mucocele treated from January 1983 to December 1998 at the Department of Surgery, Masan Samsung Hospital.
RESULTS
There were 3 males and 13 females aged 44 to 83 years (mean 59.3 years). The peak incidence was in the 6th decade (6 cases, 37.5%). The most common symptom was right lower quadrant pain, and right lower quadrant tenderness was the most common physical finding. Histopathologic diagnoses were mucosal hyperplasia in 12 cases and mucinous cystadenoma in four. Simple appendectomy was performed in 8 patients with uncomplicated mucosal hyperplasia. Right hemicolectomy was performed in 3 patients with mucinous cystadenoma. Ileocecal resection was performed in one patient with mucosal hyperplasia and in another patient with mucinous cystadenoma. Appendectomy and oophorectomy was performed in 2 patients with mucosal hyperplasia and coexisting ovarian cyst, and appendectomy and fistulectomy, in one patient with mucosal hyperplasia and coexisting appendiceocutaneous fistula. Postoperative complications such as intestinal obstruction and wound infection occurred in 4 cases (25%). There was no postoperative mortality. Thirteen patients remain free of disease after surgical intervention, and one patient died 6 year later of peritoneal seeding caused by advanced gastric cancer.
CONCLUSIONS
Simple appendectomy is a reasonable choice for uncomplicated, unruptured mucoceles; however, a right hemicolectomy or ileocecal resection may be indicated if the mucocele is adherent to, or shows signs of invasion to cecum or ileum. At operation, a careful search should be made for 'coexisting' tumors of the ovary and gastrointestinal tract.

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