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EDITOR’S QUIZ: GI SNAPSHOT

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From question on page 1063

At laparotomy, fundal cecectomy, including appendectomy, was performed. The peritoneum was normal. The specimen consisted of a 3×4×9 cm cystic appendiceal mass with the appearance of a “chicken drumstick”, filled with yellowish gelatinous mucus. The pathological diagnosis was mucinous cystadenoma.

Appendiceal mucocele, appendiceal distension with mucus, are present in approximately 0.2–0.3% of appendectomy specimens. Most patients present with appendicitis or palpable mass but asymptomatic neoplasms may be found incidentally. Appendiceal mucocele are classified histologically into several groups: retention cysts, mucosal hyperplasia without atypia, mucinous cystadenoma, and mucinous cystadenocarcinoma. Colonoscopic image of the appendiceal orifice observed in the top of the submucosal mound is called the “volcano sign”. Computed tomographic detection of appendiceal cystic dilatation with curvilinear mural calcification is quite reliable for the preoperative diagnosis. These lesions should be resected because rupture of the lesion may result in pseudomyxoma peritonei. The patient recovered uneventfully and remains asymptomatic.

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