Asian Journal of Case Reports in Surgery

Low Grade Appendiceal Neoplasm: A Case Report

Vikas Chalotra

Department of General Surgery, Guru Gobind Singh Medical College and Hospital, Faridkot, India.

Sarabjeet Singh

Department of General Surgery, Guru Gobind Singh Medical College and Hospital, Faridkot, India.

Natasha Nuna *

Department of General Surgery, Guru Gobind Singh Medical College and Hospital, Faridkot, India.

Shubham Garg

Department of General Surgery, Guru Gobind Singh Medical College and Hospital, Faridkot, India.

*Author to whom correspondence should be addressed.

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Abstract

Mucinous tumors of appendix are not frankly malignant, but if ruptured can result in intraperitoneal spread and development of pseudomyxoma pertonei [PMP]. At the lower end of spectrum are Low grade mutinous neoplasm [LAMN], which have been historically called mucoceles of appendix and  accounts for less than 0.3% of appendectomy findings. We present the case of 33 years old male who had complaints of sudden onset of   pain abdomen for 5 days. Computer tomography was done with evidence of dilatation of appendix with cystic lesion of 50*43mm.The patient underwent laparotomy with right hemicolectomy. The histology report showed a low grade appendiceal neoplasm. Therefore LAMN should be considered as one of the differentials in patients presenting with acute abdomen and right iliac fossa mass.

Keywords: Acute appendicitis, low grade appendiceal neoplasms, rare cancer, pseudomyxoma peritonei

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References

Fournier K, Rafeeq S, Taggart M et al. Low grade appendiceal mucinous neoplasm of uncertain malignant potential [LAMN-UMP]: Prognostic factors and implications for treatment and follow-up. Ann Surg Oncol. 2017;24:187-93.

Klag T, Wehkamp J, Bosmuller H et al. Low-grade appendiceal mucinous neoplasm [LAMN]- 3 yaers endoscopic follow up underlines benign course of LAMN type 1. Z Gastroenterol. 2017;55: 149-52.

Rymer B, Forsythe RO, Husada G. Mucocele and nucinous tumours of the appendix : A review of the literature. Int J Surg. 2015;18:132-5.

Pai RK, Beck AH, Norton JA et al. Appendiceal mucinous neoplasms: Clinicopathological study of 116 cases with analysis of factors predicting recuurence. Am J Surg Pathol. 2009;33:1425-1439.

Higa E, Rosai J, Pizzimbono CA et al. Mucosal hyperplasia, mucinous cystadenoma and mucinous cystadenocarcinoma of the appendix. A re-evaluation of appendiceal mucocele. Cancer. 1973;32:1525-1541.

Misdraji J, Yantiss RK, Graeme –Cook FM et al. Appendiceal mucinous neoplasms: A clinicopathologocal analysis of 107 cases. Am J Surg Pathol. 2003;27:1089-1103.

Umetsu SE, Shafizadeh N, Kakar S. Grading and staging mucinous neoplasms of the appendix : A case seires and review of the literature. Hum Pathol. 2017;69:81-9.

Agrusa A, Romano G, Galia M, Cucinella G, Sorce V et al. Appendiceal mucinous neoplasm : An uncertain nosological entity. R Eort of a case. G Chir. 2016;37:86-9.

Dixit A, Robertson JH, Mudan SS, Akle C. Appendiceal muucoceles and pseudomycoma peritonei. World J Gastroenterol. 2007;13(16);2381-4.

Carr NJ, Cecil TD, Mohamed F et al. A consenses for classification and pathologic reporting of pseudomyxoma peritonei and associated appendiceal neoplasia. Am J Surg Pathol. 2016;40:14-26.

Mohanty AK, Anand G, Nemec J, Alnajjar A, Albarrak J. Low grade appendiceal mucinous neoplasm- rare neoplasm ; A case reort. J Cancer Prev Curr Res. 2018;9;77-9.

Bell PD, Huber AR, Drage MG, Barron SL et al. Clinicopathologic features of low – grade appendiceal mucinous neoplasm : A single institution experience of 117 cases. Am J Surg Pathol. 2020;44(11):1549-55.

Kehagias I, Zygomalas A, Markopoulos G et al. Diagnosis and treatment of mucinous appendiceal neoplasm presented as acute appendicitis. Case Reo Oncol Med. 2016; 2016:2161952.

Zhou ML, Yan FH, Xu PJ et al. Mucinous cystadenoma of appendix: CT findings. Chin Med J. 2006;119;1300-3.

Carmignani CP, Hampton R, Sugarbaker CE et al. Utility of CEA and CA 19.9 tumor markers in diagnosis and prognostic assessment of mucinous epithelial cancers of appendix. J Surg Oncol. 2004;87:162-6.