Case: 263

Appendiceal Mucinous Adenocarcinoma

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History: 57 yo female with RLQ pain.
Solution: Mucinous neoplasms are rare in the gastrointestinal tract, but the most common site is the appendix. There are different types of mucin producing tumours that can occur in the appendix, both benign and malignant. The most common malignancy of the appendix is mucinous adenocarcinoma as in this case. It generally presents as appendicitis and the diagnosis is often made on pathology after appendectomy. If not performed at the time of the appendectomy, complete treatment of limited disease usually requires right hemicolectomy. It can metastasize to the lymph nodes, liver and lungs and has a worse prognosis than most appendiceal neoplasms. The secondary finding in this case is the potential liver metastasis.

Questions

The primary abnormality is centered in the:
  • Liver
  • Kidney
  • Appendix
  • Cecum
  • Uterus
  • Small bowel
The most appropriate next step for this patient would be surgery.
True
Please provide a differential diagnosis of 3 things. Extra credit if you get the actual diagnosis.
Mucinous adenocarinoma of the appendix.