Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2021; 9(35): 11056-11060
Published online Dec 16, 2021. doi: 10.12998/wjcc.v9.i35.11056
Treatment of a giant low-grade appendiceal mucinous neoplasm: A case report
Rong Xu, Zhi-Long Yang
Rong Xu, Department of Gynecology and Obstetrics, Nanjing Lishui People’s Hospital, Nanjing 211200, Jiangsu Province, China
Zhi-Long Yang, Department of General Surgery, Nanjing Lishui People’s Hospital, Nanjing 211200, Jiangsu Province, China
Author contributions: Xu R contributed to the data collection, interpretation, writing the paper, editing the paper; Yang ZL contributed to the study concept, data interpretation, writing the paper, editing the paper; and all authors read and approved the manuscript for publication.
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 have no conflicting interests.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Long Yang, MM, Chief Doctor, Department of General Surgery, Nanjing Lishui People’s Hospital, No. 86 Chongwen Road, Nanjing 211200, Jiangsu Province, China. 641952830@qq.com
Received: June 10, 2021
Peer-review started: June 10, 2021
First decision: July 15, 2021
Revised: July 28, 2021
Accepted: September 16, 2021
Article in press: September 16, 2021
Published online: December 16, 2021
Processing time: 182 Days and 21.2 Hours
Abstract
BACKGROUND

Low-grade appendiceal mucinous neoplasm (LAMN) is extremely rare and easily misdiagnosed before surgery.

CASE SUMMARY

We report the treatment of an asymptomatic case of LAMN diagnosed by magnetic resonance imaging (MRI) and surgical findings. A 70-year-old woman presented with an adnexal mass found by physical examination in July 2020. Gynecologic ultrasonography revealed a cystic mass in the right adnexa, and computed tomography showed a cystic mass in the pelvic cavity. All tumor markers were normal. A further MRI examination suggested mucinous neoplasm in the right pelvic cavity, excluding the possibility of adnexal cyst. Laparoscopic exploration found a huge cystic mass of about 10 cm × 7 cm that originated from the apex of the appendix, with spontaneous rupture. LAMN was confirmed by pathological examination. As of May 2021, no disease recurrence occurred after an open appendectomy.

CONCLUSION

This case indicates that we should pay more attention to female patients who are clinically diagnosed with an adnexal mass at admission,. The physical examination should be done carefully, and the laboratory and imaging examination results should be comprehensively analyzed to avoid misdiagnosis and to ensure prompt diagnosis and treatment, and to improve prognosis. MRI may be a better option for the diagnosis of appendiceal mucinous neoplasm.

Keywords: Appendiceal mucinous neoplasm, Diagnosis, Cystic mass, Pelvic cavity, Appendectomy, Case report

Core Tip: Low-grade appendiceal mucinous neoplasm (LAMN) is extremely rare and easily misdiagnosed before surgery. We report the treatment of an asymptomatic case of LAMN diagnosed by magnetic resonance imaging and surgical findings. This case indicates that we should pay more attention to female patients who are clinically diagnosed with an adnexal mass at admission,. The physical examination should be done carefully, and the laboratory and imaging examination results should be comprehensively evaluated to avoid misdiagnosis and ensure prompt diagnosis and treatment, and to improve prognosis.