Rare presentation of low-grade appendiceal mucinous neoplasms (LAMN) as an appendicular lump: A case report

ABSTRACT:

Introduction

The prevalence of appendiceal mucinous neoplasms (AMN) is about 0.2%–0.3% in the specimens of the appendix. The LAMN may appear unremarkable or can present as mucin-filled, crystally dilated tissues. The diagnosis of early-stage AMN is mostly incidental. It is of vital importance to know the features of LAMN for a timely diagnosis

Case presentation

A 46-year-old male came with the complaint of right iliac fossa swelling along with severe intensity pain and a single episode of vomiting. A 4 × 4cm tender, soft, cystic, mobile swelling was found upon the examination. Contrast-enhanced Computerized tomography (CT) scan of the abdomen revealed the appendix diameter of 10mm well-circumscribed cystic measuring 2.1 × 2 cm. Therefore, an open resection surgery was performed. The histopathological report revealed an intraepithelial lesion composed of flat mucinous epithelial cells having eosinophilic cytoplasm and low-grade nuclear atypia.

Case discussion

The AMNs are very rare neoplasms. The imaging modalities that can be diagnostic methods are abdominal and transvaginal ultrasonography (US), and abdominal computed tomography (CT). The low-grade features of the appendiceal mucinous neoplasms have the possibility of recurrence. The CT-scan findings of appendiceal lump>1.3cm along with cystic dilation and the calcification of the wall are the suggestive features of AMN. There is a high chance of dissemination and port site seeding in case of pneumoperitoneum.

Conclusion

This rare case suggests the significance of adding AMNs as a differential diagnosis in patients with abdominal pain and choosing the right approach to treat such patients to avoid complications. Highlights • The incidence of low-grade appendiceal mucinous neoplasms (LAMN) is quite low.• The diagnosis of the LAMN is incidental and should be included in the differentials for abdominal pain.• There should be proper examination along with appropriate investigations for patients presenting with abdominal pain.• The timely diagnosis and the appropriate management allow better outcomes.• Laparoscopy is preferred as compared to open resection.

SUBMITTER: Fatima K 

PROVIDER: S-EPMC9793229 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature