INTESTINE Vol.12 No.1(2-6-4)

Theme Mesenchymal neoplasms of the colon and rectum : excluding lymphoproliferative disorders
Title Mucinous cystadenoma and mucinous cystadenocarcinoma of appendix
Publish Date 2008/01
Author Shinsuke Kiriyama Division of Endoscopy, National Cancer Center Hospital
Author Yutaka Saito Division of Endoscopy, National Cancer Center Hospital
[ Summary ] Mucinous cystadenoma of the appendix is a rare relatively disease, which leads to mucus collection in the appendix. It is also indicated by a state of expansion of the appendix in part or as a whole. Mucinous cystadenocarcinoma of the appendix accounts for more than half of the cases of primary appendix cancer. There are no characteristic symptoms in either disease. When a diagnosis is too late and the tumor has burst, the progresses will indicate pseudomyxoma peritonei.
Leiomyoma, painless appendicitis, ovarian tumors and metastatic tumors may be ruled out in these case.
With colonoscopy, mucinous cystadenoma and cystadenocarcinoma may be indicated as submucosal tumors in the appendix. Mucosal tissues surrounding the tumor is termed a “headband fold”. A volcano sign is the characteristic sign in which there is a hole in the appendix on top of a submucosal tumor like elevation.
Mucinous cystadenocarcinoma sometimes has nodal lesions in the wall. The localized nodal segment suggests a malignant potential, as seen in CT and MRI scans. However, with in colonoscopies and barium enemas, there are no characteristic views indicating early cancer. Therefore, it's important not to overlook the appearance of mucinous cystadenoma.
The diameter of tumors is not associated with the degree of malignancy according to our data. Submucosal tumors over 20 mm in size must be recognized, along with indications of leiomyoma. It's also necessary to consider additional diagnostic modalities when mucinous cystadenoma is observed.
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