Clinical Gastroenterology Vol.14 No.11(2-5)

Theme Disease of Appendix and its Allied Condition
Title Appendiceal Mucocele and Pseudomyxoma Peritonei
Publish Date 1999/10
Author Masakatsu Sunagawa First Department of Surgery, Dokkyo University School of Medicine
[ Summary ] In the appendiceal mucocele condition the lumen is dilated and contains larger amounts of glairy mucus. The histological patterns are simple(obstructive) mucocele, mucinous cystadenoma and mucinous cystadenocarcinoma. Preoperative diagnosisof mucocele is rare. Though there are no typical clinical findings, X-P, CF, CT and US are useful methods in diagnosing mucocele. With barium enemas, the lesion may be seen as a sharply outlined submucosal tumor. With CT and US examinations, the mucocele usually appears as a well-encapsulated cystic mass, with a density ranging from nearly that of water to that of soft tissue. When a malignant mucocele ruptures into the abdomen, mucus-secreting malignant cells are shed into the peritoneal cavity. This gives rise to the condition known as pseudomyxoma peritonei. It is thought to be related to metastasis of cystadenocarcinoma of the appendix. The long-term prognosis for the patient is poor. Combined therapies such as surgery, chemotherapy and mucolytic therapy are recommended.
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