Scaffa C, Di Bella O, Tartaglia E, Rotondi M, Lup F, Messalli E M
Department of Gynaecology, Obstetrics and Reproductive Medicine Second University of Naples, Naples, Italy.
Eur J Gynaecol Oncol. 2007;28(6):503-5.
Mucocele of the vermiform appendix is a rare disease of the appendix caused by mucoid substance retention in its lumen, due to obstruction or hyperproduction due to appendiceal retention cysts, mucosal hyperplasia, mucinous cystadenomas and cystadenocarcinomas. Therefore, also appendiceal malignancy can be the underlying cause, making accurate preoperative diagnosis imperative, even if this disease is often asymptomatic and an early diagnosis still remains very difficult on imaging studies. In women, appendiceal mucoceles can sometimes present on clinical and instrumental findings as a right adnexal mass mimicking an ovarian neoplasm. A rare case of appendiceal mucocele in a 36-year-old women with a right-sided painful pelvic mass is presented. The mucocele was misdiagnosed as a cystic complex mass of the right adnexa both clinically and ultrasonographically. Serum levels of CEA and CA19-9 were increased. Explorative laparoscopy was performed revealing an enlarged vermiform appendix with the uterus and adnexa macroscopically normal, and no signs of intraperitoneal metastasis or adnexal torsion. Laparotomic appendectomy followed. Histological examination revealed a mucinous cystadenoma of the vermiform appendix. This clinical entity of appendiceal mucocele should always be considered by gynaecologists as well as gastroenterologists in the differential diagnosis of patients presenting a right-sided adnexal mass on ultrasound in order to choose the best surgical approach.
阑尾黏液囊肿是一种罕见的阑尾疾病，由阑尾管腔内黏液样物质潴留引起，其原因包括梗阻或因阑尾潴留囊肿、黏膜增生、黏液性囊腺瘤及囊腺癌导致的黏液过度分泌。因此，阑尾恶性肿瘤也可能是其潜在病因，这使得术前准确诊断至关重要，即便该疾病通常无症状，且在影像学检查中早期诊断仍非常困难。在女性患者中，阑尾黏液囊肿有时在临床和检查结果上可表现为右侧附件区肿物，类似卵巢肿瘤。本文报道了一例36岁女性阑尾黏液囊肿病例，该患者有右侧盆腔疼痛性肿物。黏液囊肿在临床和超声检查中均被误诊为右侧附件区的复杂性囊性肿物。癌胚抗原（CEA）和糖类抗原19-9（CA19-9）血清水平升高。进行了腹腔镜探查，术中见阑尾肿大，子宫和附件肉眼观正常，无腹膜转移或附件扭转迹象。随后行剖腹阑尾切除术。组织学检查显示为阑尾黏液性囊腺瘤。妇科医生和胃肠病学家在鉴别诊断超声提示右侧附件区肿物的患者时，应始终考虑阑尾黏液囊肿这一临床实体，以便选择最佳手术方式。
