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A rare presentation of low-grade appendiceal mucinous neoplasm within an amyand’s hernia: a case report: Hani Atiqah Saim, Ian Chik, Fahrol Fahmy Jaafar, Zamri Zuhdi, Razman Jarmin, Azlanudin Azman; Ann Coloproctol. 2023;39(2):183-187. Published online October 18, 2021; DOI: https://doi.org/10.3393/ac.2021.00430.0061

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An Amyand’s hernia is characterised as the presence of the appendix in an inguinal hernial sac. During laparoscopic cholecystectomy for gallbladder polyps, an incidental Amyand’s hernia was discovered in a 75-year-old female patient. On examination, the hernia contained an appendiceal mucocele but no evidence of perforation. An open appendicectomy with tension-free mesh repair was performed for the hernia. The histopathological report of the appendix was a low-grade appendiceal mucinous neoplasm (LAMN), an entity that is just as rare as an Amyand’s hernia. The patient had the right inguinal swelling for over 10 years but it was thought to be an inguinal intramuscular cyst as reported on a previous abdominal ultrasound. Mucocele of the appendix may have a benign or malignant appendiceal progress, leading to individualised diagnosis and treatment. We review an Amyand’s hernia with LAMN and discuss the asymptomatic tendency yet malignant potential of appendiceal mucoceles along with treatment strategies.

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Molecular characterization of Pseudomyxoma peritonei with single-cell and bulk RNA sequencing
Ye Jin Ha, Seong-Hwan Park, Seon-Kyu Kim, Ka Hee Tak, Jeong-Hwan Kim, Chan Wook Kim, Yong Sik Yoon, Seon-Young Kim, Jong Lyul Lee
Scientific Data.2025;[Epub] CrossRef
Incidental appendiceal mucocele discovery: A case series and literature review
Nathaniel Grabill, Mena Louis, Jonathan W. Ray, Ana Tucker, Travelyan Walker, James Chambers
International Journal of Surgery Case Reports.2025; 131: 111281. CrossRef
Complicated Appendicitis Associated With Appendiceal Mucinous Neoplasm Within Amyand’s Hernia in a Patient With Previous Hernia Repair: A Case Report and Literature Review
Carlos A Navarro-Castañeda, Luis A Pérez-Silva, Rubén A Sandoval-Barba, Nubia A Ramírez-Buensuceso-Conde, Jorge Farell-Rivas
Cureus.2024;[Epub] CrossRef

Benign GI diease,Rare disease & stoma

Impending Rupture With a Twisted Huge Appendiceal Mucocele Treated With Totally Laparoscopic Resection: A Case Series: Hong-min Ahn, Si-Hak Lee; Ann Coloproctol. 2021;37(Suppl 1):S34-S38. Published online June 29, 2021; DOI: https://doi.org/10.3393/ac.2020.00150.0021

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Abstract PDF

Torsion of the appendix is rare, and appendiceal mucocele can be one of its causes. The first case was of a 49-year-old man who visited the emergency room (ER) for abdominal pain. Abdominal computed tomography (CT) showed appendiceal mucocele with suspected torsion and rupture. The patient underwent laparoscopic exploration and appendectomy. The second case was of a 69-year-old man who visited the ER for epigastric pain. Abdominal CT showed suspicious appendiceal mucocele with ischemic change, indicating torsion of the appendix. The twisted appendix was successfully removed by laparoscopic exploration. An appendiceal mucocele is one of the causes of twisted appendix. With torsion, the mucocele can be diagnosed as rupture by ischemia which may lead to pseudomyxoma peritonei. For this reason, open laparotomy has traditionally been preferred. However, an unruptured appendiceal mucocele or impending rupture with torsion of the appendiceal mucocele can be treated with totally laparoscopic surgery.

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Torsion of Low-Grade Appendiceal Mucinous Neoplasm (LAMN): A Case Report
Hideo Kidogawa, Ryo Nonomura, Keizaburou Maruyama, Takashi Okimoto, Kohji Okamoto
Cureus.2024;[Epub] CrossRef
Uncommon cause of acute appendiceal torsion mucocele
Munyaradzi Gift Nyandoro, Vignesh Kumar Palanisamy, Rajesh Kumar Singh
BMJ Case Reports.2022; 15(7): e249175. CrossRef
Benign multicystic mesothelioma of appendiceal origin treated by hyperthermic intraperitoneal chemotherapy: A case report
Suk Jun Lee, Ji Hae Nahm, Jeonghyun Kang, Seung Hyuk Baik, Eun Jung Park
International Journal of Surgery Case Reports.2022; 99: 107665. CrossRef

Original Article

Benign GI diease,Malignant disease,Minimally invasive surgery

Surgical Outcomes of Single-Port Laparoscopic Surgery Compared With Conventional Laparoscopic Surgery for Appendiceal Mucinous Neoplasm: In Jun Yang, Minseol Seo, Heung-Kwon Oh, Jeehye Lee, Jung Wook Suh, Duck-Woo Kim, Sung-Bum Kang; Ann Coloproctol. 2021;37(4):239-243. Published online June 4, 2021; DOI: https://doi.org/10.3393/ac.2020.11.08

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Abstract PDF

Purpose
This study aimed to evaluate the safety and feasibility of single-port laparoscopic surgery (SLS) for appendiceal mucinous neoplasm (AMN) when compared with conventional laparoscopic surgery (CLS).
Methods
This retrospective study enrolled patients who underwent surgery for AMN between July 2014 and June 2020 at Seoul National University Bundang Hospital. Patient demographics, surgical data, pathology, hospital stay, postoperative morbidity, and follow-up data were extracted from electronic records for analysis.
Results
We enrolled 18 patients who underwent SLS and 22 who underwent CLS. The SLS group included patients who underwent partial cecectomy (14 patients), ileocecectomy (3 patients), and right hemicolectomy (1 patient). The CLS group included patients who underwent appendectomy (4 patients), partial cecectomy (11 patients), ileocecectomy (5 patients), and right hemicolectomy (2 patients). Operation type was not significantly different between groups (P = 0.213). No patient required open surgery in the SLS group in contrast to the CLS group (13.6%; P = 0.238). The operative time tended to be shorter in the SLS group than the CLS group (median [interquartile range]: 52.5 minutes [40–65.2 minutes] and 60 minutes [40–120 minutes], respectively; P = 0.251). Morbidity was 5.5% in the SLS group and 9.0% in the CLS group (P = 0.692). Surgical margins were clear in all cases. The median duration of postoperative hospital stay was 2.0 and 4.0 days in the SLS and CLS groups, respectively (P = 0.013). No recurrence occurred in either group during follow-up.
Conclusion
This study indicates that SLS is a safe and feasible surgical approach for AMN.

Citations

Citations to this article as recorded by

Outcomes of laparoscopic single-incision caecal pole resection for low-grade appendiceal mucinous neoplasm
Han Deok Kwak
Journal of Minimal Access Surgery.2025; 21(2): 107. CrossRef
Isolated Growth Hormone Deficiency IA due to a Novel Homozygous Large Deletion ∼1.6 kb Spanning Exons 1–4 of GH1 Gene: A Case Report
Shahab Noorian, Hedieh Soltani, Fatemeh Aghamahdi, Shahram Savad, Mahnaz Seifi Alan
Clinical Case Reports.2025;[Epub] CrossRef
Clinical outcome and survival of low-grade appendiceal mucinous neoplasm with different surgical treatment: A multicenter clinical retrospective study
Cunlong Lu, Zhenlong Han, Hui Gao, Yongke Liu, Long Li, Tuo Shi, Houxin Zhu, Zhaoli Liu, Liangdong Cheng, Yanbing Zhou
Clinical Surgical Oncology.2025; 4(1): 100075. CrossRef
Impact of single-port laparoscopic approach on scar assessment by patients and observers: a multicenter retrospective study
Sung Uk Bae, Kyeong Eui Kim, Chang-Woo Kim, Ji-Hoon Kim, Woon Kyung Jeong, Yoon-Suk Lee, Seong Kyu Baek, Suk-Hwan Lee, Jun-Gi Kim
Annals of Coloproctology.2025; 41(2): 154. CrossRef
Unusual giant low-grade appendiceal mucinous neoplasm: A case report and literature review
Xuhui Ma, Wei Dong, Qing Yang, Jie Yu, Shunchang Zhou, Yuxu Zhong, Haibo Chu
Medicine.2025; 104(23): e42828. CrossRef
Elevating surgical standards: The role of intraperitoneal isoperistaltic side-to-side anastomosis in colon cancer surgery
Sung Uk Bae
World Journal of Gastrointestinal Oncology.2025;[Epub] CrossRef
Comparison between liquid skin adhesive and wound closure strip for skin closure after subcuticular suturing in single-port laparoscopic appendectomy: a single-center retrospective study in Korea
Kyeong Eui Kim, Yu Ra Jeon, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Journal of Minimally Invasive Surgery.2024; 27(1): 14. CrossRef
Transcecal endoscopic appendectomy for management of complex appendiceal polyps extending into the appendiceal orifice
Tara Keihanian, Mai A Khalaf, Fuad Zain Aloor, Dina Hani Zamil, Salmaan Jawaid, Mohamed O. Othman
Endoscopy International Open.2024; 12(08): E932. CrossRef
Effect of intracorporeal anastomosis on postoperative ileus after laparoscopic right colectomy
Sangwoo Kim, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek, Young-Gil Son
Annals of Surgical Treatment and Research.2023; 104(3): 156. CrossRef
A prospective randomized controlled study comparing patient-reported scar evaluation of single-port versus multiport laparoscopic appendectomy for acute appendicitis
Kyeong Eui Kim, In Soo Cho, Sung Uk Bae, Woon Kyung Jeong, Hyung Jin Kim, Seong Kyu Baek
Journal of Minimally Invasive Surgery.2023; 26(2): 55. CrossRef
Benign multicystic mesothelioma of appendiceal origin treated by hyperthermic intraperitoneal chemotherapy: A case report
Suk Jun Lee, Ji Hae Nahm, Jeonghyun Kang, Seung Hyuk Baik, Eun Jung Park
International Journal of Surgery Case Reports.2022; 99: 107665. CrossRef

Case Report

Necrotizing Fasciitis Arising From an Enterocutaneous Fistula in a Case of an Appendiceal Mucocele: Keun Young Kim, Won Cheol Park; Ann Coloproctol. 2015;31(6):246-250. Published online December 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.6.246

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Abstract PDF

An appendiceal mucocele (AM) is a rare tumorous condition of the appendix. Many patients with AM are admitted to the hospital with abdominal pain or discomfort, and many cases are found incidentally. Although the rate of complications in patients with AM is very low, if left untreated, a mucocele may rupture and produce a potentially fatal entity known as pseudomyxoma peritonei. In this paper, we report a case of an 80-year-old man with necrotizing fasciitis arising from an enterocutaneous fistula caused by AM.

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Enterocutaneous fistula resulting from the drainage of a contained appendiceal perforation secondary to a partially obstructing low-grade appendiceal mucinous neoplasm
Ryan Cohen, Katie McKean, Stephanie Chetrit
BMJ Case Reports.2021; 14(8): e244546. CrossRef
Atypical presentation of appendicitis
Oliver Beaumont, Robert Miller, Richard Guy
BMJ Case Reports.2016; 2016: bcr2016217293. CrossRef

Original Articles

Single-incision Laparoscopic Surgery for Appendiceal Mucoceles: Safety and Feasibility in a Series of 16 Consecutive Cases: Ki Bum Park, Jun Seok Park, Gyu-Seog Choi, Hye Jin Kim, Soo Yeun Park, Jong Pil Ryuk, Won Ho Choi, You Seok Jang; J Korean Soc Coloproctol. 2011;27(6):287-292. Published online December 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.6.287

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Abstract PDF

Purpose

The aim of this study was to evaluate the technical feasibility, safety, and oncological outcomes of transumbilical single-incision laparoscopic surgery in patients with an uncomplicated appendiceal mucocele.

Methods

A review of a prospectively collected database at the Kyungpook National University Hospital from January 2006 to September 2010 revealed that a series of 16 consecutive patients underwent single-incision laparoscopic surgery (SILS) for an appendiceal mucocele. Data regarding patient demographics, operating time, conversion, surgical morbidity, lateral lymph node status, and mid-term oncologic result were analyzed.

Results

The reported series consisted of 7 women (50%) and 9 men with a mean age of 61.6 years (range, 41 to 88 years). The mean operative time was 66.8 minutes (range, 33 to 150 minutes). Perioperative mortality and morbidity were 0% and 6.2%, respectively. Recovery after the procedure was rapid, and the mean hospital stay was 6.8 days (range, 3 to 22 days). Pathology revealed 12 lesions compatible with a mucinous cystadenoma and four others compatible with benign cystic tumors. All surgical margins were clear. In one case, an extra port had to be placed, and another case required conversion from SILS to a standard open laparotomy immediately after identification of the tumor because of a micro-perforation with focal mucin collection. With a median follow-up of 28.7 months, no re-admission or tumor recurrence, such as pseudomyxoma peritonei, was noted in 14 patients.

Conclusion

A single-port laparoscopic mucocelectomy should be safe and feasible and has the advantage of being a minimally invasive approach. Prospective controlled studies comparing SILS and conventional open surgery, with long-term follow-up evaluation, are needed to confirm the author's initial experience.

Citations

Citations to this article as recorded by

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Appendiceal Neoplasms
Wolfgang B. Gaertner, Shaun R. Brown, Michael Deutsch, Mehraneh D. Jafari, Mukta K. Krane, Vlad V. Simianu, Michael A. Valente, Amy L. Lightner, Daniel L. Feingold, Ian M. Paquette
Diseases of the Colon & Rectum.2025; 68(7): 815. CrossRef
Appendiceal Mucocele - A Review of Literature with a Case Report
Berislav Vekic, Rade Markovic, Aleksandar Cvetkovic, Bojan Stojanovic, Marko Spasic, Nenad Markovic, Mladen Pavlovic, Dusica Petrovic, Bojan Milosevic, Jasna Jevdjic, Maja Vulovic, Dalibor Jovanovic, Slobodanka Mitrovic
Experimental and Applied Biomedical Research (EABR).2024; 25(3): 289. CrossRef
Single-incision laparoscopic surgery compared to conventional laparoscopic surgery for appendiceal mucocele: a series of 116 patients
Ho Seung Kim, Han-Gil Kim, Seung Yoon Yang, Yoon Dae Han, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim, Min Soo Cho
Surgical Endoscopy.2022; 36(1): 244. CrossRef
Mucinous appendiceal neoplasm: A case report
Alexandru Chirca, Lucian Negreanu, Andreea Iliesiu, Radu Costea
World Journal of Clinical Cases.2021; 9(7): 1728. CrossRef
Actinomycosis of the Appendix Mimicking Cecal Tumor Treated by Single-Port Laparoscopic Approach
In Soo Cho, Sung Uk Bae, Hye Ra Jung, Kyung Sik Park, Woon Kyung Jeong, Seong Kyu Baek
Annals of Coloproctology.2021; 37(2): 125. CrossRef
Surgical Outcomes of Single-Port Laparoscopic Surgery Compared With Conventional Laparoscopic Surgery for Appendiceal Mucinous Neoplasm
In Jun Yang, Minseol Seo, Heung-Kwon Oh, Jeehye Lee, Jung Wook Suh, Duck-Woo Kim, Sung-Bum Kang
Annals of Coloproctology.2021; 37(4): 239. CrossRef
The American Society of Colon and Rectal Surgeons, Clinical Practice Guidelines for the Management of Appendiceal Neoplasms
Sean C. Glasgow, Wolfgang Gaertner, David Stewart, Jennifer Davids, Karim Alavi, Ian M. Paquette, Scott R. Steele, Daniel L. Feingold
Diseases of the Colon & Rectum.2019; 62(12): 1425. CrossRef
Safety and feasibility of laparoscopic surgery for appendiceal mucocele: a multicenter study
Tae Kyu Kim, Jun Ho Park, Jeong Yeon Kim, Byung Chun Kim, Byung Mo Kang, Soo Kee Min, Jong Wan Kim
Surgical Endoscopy.2018; 32(11): 4408. CrossRef
Laparoscopic ileocecal resection can be applied for appendiceal cancer with an ileal fistula: A case report
Junko Mukohyama, Yasuo Sumi, Kiyonori Kanemitsu, Hiroshi Hasegawa, Masashi Yamamoto, Shingo Kanaji, Yoshiko Matsuda, Kimihiro Yamashita, Takeru Matsuda, Taro Oshikiri, Tetsu Nakamura, Satoshi Suzuki, Yoshihiro Kakeji
International Journal of Surgery Case Reports.2018; 52: 120. CrossRef
Minimally invasive appendectomy for resection of appendiceal mucocele: Case series and review of the literature
Sonia T. Orcutt, Daniel A. Anaya, Mokenge Malafa
International Journal of Surgery Case Reports.2017; 37: 13. CrossRef
Diagnosis and Treatment of Mucinous Appendiceal Neoplasm Presented as Acute Appendicitis
Ioannis Kehagias, Apollon Zygomalas, Georgios Markopoulos, Thanasis Papandreou, Pantelis Kraniotis
Case Reports in Oncological Medicine.2016; 2016: 1. CrossRef
Recommendations in the management of epithelial appendiceal neoplasms and peritoneal dissemination from mucinous tumours (pseudomyxoma peritonei)
P. Barrios, F. Losa, S. Gonzalez-Moreno, A. Rojo, A. Gómez-Portilla, P. Bretcha-Boix, I. Ramos, J. Torres-Melero, R. Salazar, M. Benavides, T. Massuti, E. Aranda
Clinical and Translational Oncology.2016; 18(5): 437. CrossRef
Laparoscopic approach to mucocele of appendiceal mucinous cystadenoma: feasibility and short-term outcomes in 24 consecutive cases
Ki-Jae Park, Hong-Jo Choi, Sung-Heun Kim
Surgical Endoscopy.2015; 29(11): 3179. CrossRef
Cholecystectomy: evolution of laparoscopic approach
I. V. Mikhin, Yu. V. Kuhktenko, M. B. Doronin
Endoskopicheskaya khirurgiya.2015; 21(1): 42. CrossRef
IV. Les recommandations

Journal de Chirurgie Viscérale.2014; 151(6): S15. CrossRef
Distinguishing between acute appendicitis and appendiceal mucocele: is this possible preoperatively?
B. Saylam, C. E. Güldoğan, F. Coşkun, V. Vural, B. Çomçalı, M. Tez
European Journal of Trauma and Emergency Surgery.2013; 39(5): 523. CrossRef

Appendiceal Mucocele.: Lim, Young Chul , Choi, Dae Hwa , Cho, Hong Rae , Ko, Byung Kyun , Nam, Chang Woo , Nah, Yang Won , Kim, Gyu Yeol; J Korean Soc Coloproctol. 2004;20(6):339-343.

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Abstract PDF: PURPOSE
An appendiceal mucocele refers to an abnormal dilatation of the appendiceal lumen by mucus. It is a rare clinical entity with a reported prevalence rate of 0.2~0.3% of all appendectomies. The purpose of our study was to identify the clinical characteristics of and the proper surgical management for appendiceal mucoceles.
METHODS
The hospital records of 24 eligible patients were reviewed. We analyzed demographic data, and pathological and clinical data.
RESULTS
There was a significant difference in size (P<0.009) between simple mucoceles (mean, 1.95 cm) and cystadenomas (mean, 3.6 cm). While ultrasonography was the most commonly used test to establish the diagnosis (14 patients), computed tomography and colonoscopy also provided fundamental information in 5 and 2 patients, respectively. An appendectomy was performed in most cases (20 cases, 83%). A cecectomy was performed in 3 cases, and an ileocecal resection was performed in only one case. Among the cases requiring a cecectomy, a laparoscopic cecectomy was performed in one case. A synchronous tumor was present in 5 cases. Three patients had gastric cancer, 1 patient had gallbladder cancer, the other one had endometriosis.
CONCLUSIONS
Our study shows that appendiceal mucoceles most frequently present as acute appendicitis and that preoperative diagnosis is difficult to make. All mucoceles should probably be removed to eliminate the chance of progression to malignancy. Also of note was the elevated incidence of associated neoplasms, especially gastrointestinal carcinomas. Some recommend surveillance colonoscopy in patients with a diagnosis of an appendiceal mucocele. We had three cases accompanied by gastric malignancy. Therefore, we suggest that surveillance gastrofiberscopy may be indicated.

Case Report

A Case of Appendiceal Mucocele with Concominant Colon Cancer.: Yang, Sang Seok , Lim, Seon Hee , Song, Chan Ho , Sheen, Dong Hyuk , Lee, Jee Youn , Han, Yoon Ju , Lim, Byeong Cheol , Kim, Nayoung , Lee, Kyeheui , Yang, Dae Hyeon , Choi, Shin Eun; J Korean Soc Coloproctol. 2000;16(5):346-350.

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Abstract PDF: The appendiceal mucocele is a rare disorder, usually found incidentally during ultrasonography or radiologic studies. Mucoceles of the appendix include benign or malignant disease. Both of benign cystadenoma and malignant cystadenocarcinoma are characterized by an obstructed, mucin-filled appendix displacing the cecum. We experienced a case of partial obstruction of large bowel who had a cystadenoma at appendix and a colon cancer at other site on operation field. Here in, we report a case of appendiceal mucocele and concominant colon cancer with the review of literatures.

Original Article

Appendiceal Mucocele.: Choi, Young cheol , Jeong, Keuk Won , Lee, Seok , choi, Hyun cheol; J Korean Soc Coloproctol. 1999;15(4):315-320.

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Abstract PDF: PURPOSE
Mucocele of the appendix is merely a descriptive term for abnormal mucus accumulation causing distension of the appendiceal lumen, irrespective of the underlying cause. If untreated, one type of mucocele may rupture producing a potentially fatal entity known as pseudomyxoma peritonei. The purpose of this study is to clarify the clinical pictures of appendiceal mucocele and to provide a guide for treatment.
METHODS
To search the clinical characteristics of appendiceal mucocele, we retrospectively investigated 16 cases of appendiceal mucocele treated from January 1983 to December 1998 at the Department of Surgery, Masan Samsung Hospital.
RESULTS
There were 3 males and 13 females aged 44 to 83 years (mean 59.3 years). The peak incidence was in the 6th decade (6 cases, 37.5%). The most common symptom was right lower quadrant pain, and right lower quadrant tenderness was the most common physical finding. Histopathologic diagnoses were mucosal hyperplasia in 12 cases and mucinous cystadenoma in four. Simple appendectomy was performed in 8 patients with uncomplicated mucosal hyperplasia. Right hemicolectomy was performed in 3 patients with mucinous cystadenoma. Ileocecal resection was performed in one patient with mucosal hyperplasia and in another patient with mucinous cystadenoma. Appendectomy and oophorectomy was performed in 2 patients with mucosal hyperplasia and coexisting ovarian cyst, and appendectomy and fistulectomy, in one patient with mucosal hyperplasia and coexisting appendiceocutaneous fistula. Postoperative complications such as intestinal obstruction and wound infection occurred in 4 cases (25%). There was no postoperative mortality. Thirteen patients remain free of disease after surgical intervention, and one patient died 6 year later of peritoneal seeding caused by advanced gastric cancer.
CONCLUSIONS
Simple appendectomy is a reasonable choice for uncomplicated, unruptured mucoceles; however, a right hemicolectomy or ileocecal resection may be indicated if the mucocele is adherent to, or shows signs of invasion to cecum or ileum. At operation, a careful search should be made for 'coexisting' tumors of the ovary and gastrointestinal tract.

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