Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 16, 2024; 12(2): 361-366
Published online Jan 16, 2024. doi: 10.12998/wjcc.v12.i2.361
Asymptomatic low-grade appendiceal mucinous neoplasm: A case report
Min-Quan Yao, Yu-Peng Jiang, Yuan-Yu Wang, Yi-Ping Mou, Jin-Xing Fan
Min-Quan Yao, Yu-Peng Jiang, Department of Gastrointestinal Surgery, Tongxiang First People’s Hospital, Jiaxing 314500, Zhejiang Province, China
Yuan-Yu Wang, Yi-Ping Mou, Department of General Surgery, Zhejiang Provincial People’s Hospital, Hangzhou 310014, Zhejiang Province, China
Jin-Xing Fan, Endoscopy Center, Tongxiang First People’s Hospital, Jiaxing 314500, Zhejiang Province, China
Author contributions: Yao MQ and Jiang YP wrote the manuscript; Wang YY collected the information and images; Mou YP and Fan JX reviewed the manuscript; All authors were involved in drafting the manuscript and critically revising it for important intellectual content, read and approved the final manuscript, and take public responsibility for appropriate portions of the content and have agreed to be accountable for all aspects of the work.
Supported by Scientific Research Fund of National Health Commission of China, Key Health Science and Technology Program of Zhejiang Province, No. WKJ-ZJ-2201; Key Project of Social Welfare Program of Zhejiang Science and Technology Department, “Lingyan” Program, No. 2022C03099; and Clinical Research Fund Project of Zhejiang Medical Association, No. 2021ZYC-A173.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they do not have any relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Xing Fan, BSc, Nurse, Endoscopy Center, Tongxiang First People’s Hospital, No. 1918 Jiaochang East Road, Jiaxing 314500, Zhejiang Province, China. 116304728@qq.com
Received: August 21, 2023
Peer-review started: August 21, 2023
First decision: November 20, 2023
Revised: December 5, 2023
Accepted: December 26, 2023
Article in press: December 26, 2023
Published online: January 16, 2024
Processing time: 142 Days and 14.3 Hours
Abstract
BACKGROUND

Low-grade appendiceal neoplasms (LAMN) are characterized by low incidence and atypical clinical presentations, often leading to misdiagnosis as acute or chronic appendicitis before surgery. The primary diagnostic tool for LAMN is abdominal computed tomography (CT) imaging. Surgical resection remains the cornerstone of LAMN management, necessitating en bloc tumor excision to minimize the risk of iatrogenic rupture. Laparoscopy, known for its minimal invasiveness, reduced postoperative discomfort, and expedited recovery, is a safe and reliable approach for LAMN treatment. Despite the possibility of pseudomyxoma peritonei development, appendectomy and partial appendectomy generally result in negative tumor margins and favorable outcomes, which can be attributed to the disease’s slow growth and lower malignancy.

CASE SUMMARY

A 71-year-old male patient was admitted to our hospital with a pelvic space-occupying lesion detected 1 mo prior. Physical examination showed a soft abdomen without tenderness or rebound and no palpable masses. No shifting dullness was noted, and digital rectal examination revealed no palpable mass. Enteroscopy revealed a raised, smooth-surfaced mass measuring 3.0 cm in the cecum. Abdominal contrast-enhanced CT showed a markedly thickened and dilated appendix with visible cystic shadows. Laparoscopic surgery was performed and revealed a significantly dilated appendix, leading to laparoscopic resection of the appendix and part of the cecum. Post-surgical pathologic analysis confirmed LAMN. The patient received symptomatic and supportive post-operative care and was discharged on postoperative day 4 without complications such as abdominal bleeding, intestinal obstruction, or incision infection. No tumor recurrence was observed during a 7-mo follow-up period.

CONCLUSION

LAMN is a rare disease that lacks specific clinical manifestations. Abdominal CT plays a crucial role in diagnosing LAMN, and laparoscopic surgery is a safe and effective diagnostic and therapeutic approach.

Keywords: Low-grade appendiceal mucinous neoplasm; Pseudomyxoma peritonei; Computed tomography; Laparoscopy; appendectomy; Case report

Core Tip: This study presents a case of asymptomatic low-grade appendiceal neoplasm (LAMN), highlighting the crucial role of abdominal computed tomography in its diagnosis. The early identification and treatment of LAMN are essential for mitigating the risk of pseudomyxoma peritonei and enhancing patient outcomes. Laparoscopic surgery is demonstrated to be a safe and effective diagnostic and therapeutic approach.