Appendix Mucocele: A case review
Vanita Suthar-Grady, Queen Alexandra Hospital, Portsmouth.
Background
Appendix mucoceles are a rare finding presenting in 0.2-0.3% of surgical appendectomy specimens. There are 4 main types; Mucosal hyperplasia, Mucinous neoplasm of the appendix, appendiceal carcinoid and an adjacent caecal tumour. The result is obstruction of the appendiceal lumen and accumulation of mucous. The discovery of a mucocoele is usually incidental as patients are asymptomatic and prognosis is usually positive if no mucous cells are noted within the peritoneum.
Case Report
This report reviews a 70 year old patient with a palpable mass within the right adnexa and no previous significant clinical history. She was known to have fibroids and the initial assessment with ultrasound was requested through her gynaecologist. The ultrasound demonstrated a 10 cm tubular heterogeneous structure seen separate to the right ovary and extending from the caecum. While the patient was in the department she was reviewed by a Specialist GI Sonographer. Appearances were concluded to be in keeping with an appendiceal mucocoele and review with CT and Colorectal opinion was recommended.
Discussion
Advanced Ultrasound Practitioners need to be able to appreciate findings of indeterminate pelvic mass as timely management can have improved prognosis for the patient in rare cases. As this is the common modality of choice for initial assessment, Advanced Ultrasound Practitioners need to be able to assess findings even if they are outside their scope of their practice.