Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2019; 7(13): 1726-1731
Published online Jul 6, 2019. doi: 10.12998/wjcc.v7.i13.1726
Giant low-grade appendiceal mucinous neoplasm: A case report
Jian-Ming Yang, Wei-Hao Zhang, Dan-Dan Yang, Hao Jiang, Lei Yu, Feng Gao
Jian-Ming Yang, Wei-Hao Zhang, Dan-Dan Yang, Hao Jiang, Lei Yu, Feng Gao, Department of Colorectal Cancer Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin 150000, Heilongjiang Province, China
Author contributions: As the resident caring for the patient, Yang JM proposed the idea of writing this case report and wrote most of the manuscript; Yu L and Gao F participated in critical analysis of the case and literature information and in revision of the manuscript for intellectual content; Zhang WH, Yang DD, and Jiang H reviewed medical records and collected the relevant images and clinical data; all authors declare that they have read and agreed to the final manuscript.
Supported by Wu Jieping Medical Foundation of China, No. 320.6750.18492; and the Innovative Talents Fund of Harbin Science and Technology Bureau of China, No. 2015RAQYJ103.
Informed consent statement: The patient and her family members provided written informed consent.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
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 which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Feng Gao, PhD, Professor, Surgical Oncologist, Department of Colorectal Cancer Surgery, Second Affiliated Hospital of Harbin Medical University, No. 148, Baojian Road, Nangang District, Harbin 150000, Heilongjiang Province, China. gf9777@126.com
Telephone: +86-451-86297661
Received: January 30, 2019
Peer-review started: January 31, 2019
First decision: April 18, 2019
Revised: May 7, 2019
Accepted: May 23, 2019
Article in press: May 23, 2019
Published online: July 6, 2019
Processing time: 157 Days and 9.4 Hours
Abstract
BACKGROUND

Appendiceal mucinous neoplasm (AMN) is extremely rare. Since the disease does not manifest a characteristic profile of clinical symptoms, it is easy to misdiagnose and still difficult to diagnose without operation. Here, we report a case of low-grade AMN (LAMN) and summarize its clinical features, diagnosis, and treatment.

CASE SUMMARY

A 63-year-old postmenopausal woman presented with a history of right lower abdominal mass. The patient underwent laparotomy, which showed an appendiceal mucocele originating from the apex of the appendix, and a simple appendectomy was performed. The subsequent histological assessment identified an LAMN with no lymph node involvement and negative surgical margin. The patient received six cycles of chemotherapy after surgery, and to date, more than a year after the surgery, the patient remains in good health.

CONCLUSION

A unified, standardized, detailed, and accurate pathological diagnosis is needed for LAMN, to facilitate selection of an appropriate surgical plan. In addition, the surgeon should record the details of the tumors in the surgical records in order to facilitate follow-up after surgery.

Keywords: Mucocele of appendix; Appendiceal mucinous neoplasm; Low-grade appendiceal mucinous neoplasm; Pathological profile; Diagnosis; Case report

Core tip: Appendiceal mucinous neoplasms (AMNs) are rare tumors. Only a few cases have been reported and most patients have no typical clinical manifestations. As such, diagnosis and treatment are a clinical challenge; even the terminology of AMN grading and staging has been controversial and is not standardized yet. Malignant AMNs have a poor curative effect and no treatment standard has been established. Here, we report a female patient with AMN who has survived throughout follow-up, now at 1 year post-surgery. A review of the latest literature is also provided to improve the overall awareness and understanding of this disease.