Low-grade appendicial mucinous neoplasm presenting with obstructed inguinal hernia: a rare association

  • Abhishek Chowdhury
  • Keya Basu
  • Uttara Chatterjee
  • Chhanda Datta
  • P.K. Sarkar
  • Manoj Kumar Choudhuri
Keywords: Appendix, Adenocarcinoma, Pseudomyxoma Peritonei, Inguinal Hernia


Low grade  appendicial  mucinous  neoplasm  is  a  rare  entity.  It  is  grouped  under  appendicial  adenocarcinoma.  Though  it  presents  commonly  with  pain  abdomen,  asymptomatic  patients  are  not  uncommon.  It  is  a  low  grade neoplasm,  but  capable  of  producing  progressive  and  fatal  disease  in  the  form  of  pseudomyxoma  peritonei.  Management in case of  localised appendicial  disease  includes  simple  appendectomy.  We came across a  patient presenting  with  obstructed  inguinal  hernia.  While performing emergency exploration,  a dilated  appendix  was  uncovered.  Appendectomy  was  done  as  a  result  and  the  histopathological  examination  of  the  appendix  revealed  that  it  was  a  low  grade  appendicial  mucinous  neoplasm.

Author Biography

Abhishek Chowdhury


1. Carr NJ, Sobin LH. Adenocarcinoma of the appendix In: Bosman FT, Carneiro F, Hruban RH, Theise ND,editors. WHO classification of Tumors of the Digestive System,4th ed Lyon, France: IARC; 2010. 122-125

2. Wang KC, Chen CH, Chen CZ, Huang HY, Jau JY, Lin TC et al. Low- grade appendicial mucinous neoplasm: a rare cause of acute abdomen. J Soc Colon Rectal Surgeon. 2012

3. Emmi S, Galasso MG, Ursino V, Scala R, Guastella T. Appendiceal mucoceles: a case report. Minerva Chir 1998; 53:807-10

4. Higa E, Rosai J, Pizzimbono CA, Wise L. Mucosal hyperplasia, mucinous cystadenoma, and mucinous cystadenocarcinoma of the appendix. A re-evaluation of appendiceal “mucocele”. Cancer 1973;32:1525-41.

5. Kim SH, Lim HK, Lee WJ, Lim JH, Byun JY. Mucocele of the appendix: ultrasonographic and CT findings. Abdom Imaging 1998;23:292-6.

6. Madwed D, Mindelzun R, Jeffrey RB Jr. Mucocele of the appendix: imaging findings. AJR Am J Roentgenol 1992; 159:69-72..

7. Kahn M, Friedman IH. Mucocele of the appendix: diagnosis and surgical management. Dis Colon Rectum 1979;22:267-9.

8. Shayani V. Mucinous cystadenoma of the cecum missed at laparoscopic appendectomy. Surg Endosc 1999;13:1236-7.

9. Machado NO, Chopra P, Pande G. Appendiceal tumour retrospective clinicopathological analysis. Trop Gastroenterol 2004;25:36-9.
Case Report