Incidental discovery of asymptomatic low-grade mucinous appendiceal tumor during paraumbilical hernia repair: A case report emphasizing intraoperative vigilance.

INTRODUCTION

Mucinous appendiceal tumor is an exceptionally rare and indolent epithelial neoplasm characterized by the production of mucin within the appendix. Here we present a rare case of a large, asymptomatic mucinous appendiceal tumor discovered incidentally during repair of a paraumbilical hernia.

CASE PRESENTATION

A 73-year-old man with a complex medical history presented with epigastric pain, nausea, vomiting, and constipation. Diagnosed with a strangulated paraumbilical hernia. During hernia repair surgery, a low-grade mucinous appendiceal tumor was accidentally discovered. Post-operative monitoring over 18 months, including colonoscopy and CT scans, showed no recurrence.

DISCUSSION

Appendiceal primary tumors, though rare, can originate from neuroendocrine or epithelial cells. Epithelial tumors, including mucinous adenocarcinoma, produce mucin, potentially leading to pseudomyxoma peritonei, characterized by mucinous ascites and abdominal swelling. These tumors are often incidentally discovered during surgery, as symptoms are nonspecific, resembling acute appendicitis or causing abdominal distension. Diagnosis requires histopathology, revealing mucin accumulation and irregular glandular structures. Treatment typically involves cytoreductive surgery with hyperthermic intraperitoneal chemotherapy to manage the condition effectively.

CONCLUSION

This case emphasizes the critical need for intraoperative vigilance and histopathological analysis in detecting appendiceal mucinous tumors during abdominal surgery, ensuring accurate diagnosis and favorable outcomes.