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Retroperitoneal mucocele of the appendix: diagnosis and management


Urology & Nephrology Open Access Journal
Mohammed Alae Touzani,1 Souhail Regragui,1 Amine Slaoui,1 Youssef Yaikoubi,2 Tariq Karmouni,1 Khalid El Khader,1 Abdellatif Koutani,1 Ahmed  Ibn Attya Andaloussi1

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Abstract

Introduction:  Appendiceal  mucocele  is  an  interesting  pathology,  given  its  rarity  and  its  tricky  management.  The  retroperitoneal  localization  is  even  more  interesting  because  of  its difficulties to diagnosis and treat. Indeed, in case of mucocele is incorrectly treated, pseudomyxoma peritonei may develop, secondary to an intraperitoneal rupture of the mass.

Case report: We present here the case of a 50-year-old woman who consulted for a mild right low back pain with palpable abdominal mass. A CT-scan performed showed a large right  retroperitoneal  mass  evoking  a  retroperitoneal  cystic  lymphangioma.  The  patient  underwent an exploratory laparotomy, which showed a large whitish retroperitoneal cyst, extending  from  the  right  iliac  fossa  to  the  right  hypochondrium.  We  suspected  during  surgery an appendiceal mucocele. During dissection, we assisted to a tumoral rupture. The peritoneal cavity was already protected by surgical drape. We went an en-bloc and complete resection of the tumor. The histological study concluded to a mucinous cystadenoma. After a one-year follow-up, control CT-scans showed no signs of recurrence.

Conclusion: Retroperitoneal appendiceal mucocele is a rare disease. A correct radiological pre-operative  diagnosis,  based  on  CT-scan,  is  important  to  avoid  severe  intraoperative  complications.

Keywords

mucocele, retroperitoneal, appendix, mucinous cystadenoma

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