Clinicopathological Features and Management of Appendiceal Mucoceles: A Systematic Review

Appendiceal mucoceles (AMs) are rare mucin-containing neoplasms with malignant potential. Lack of evidence-based data exists defining clinicopathological features for management. MEDLINE search between 1995 and 2015 was performed using search criteria “Appendix mucocele.” Systematic review of patien...

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Bibliographic Details
Published in:The American surgeon 2018-02, Vol.84 (2), p.273-281
Main Authors: Morano, William F., Gleeson, Elizabeth M., Sullivan, Sean H., Padmanaban, Vennila, Mapow, Beth L., Shewokis, Patricia A., Esquivel, Jesus, Bowne, Wilbur B.
Format: Article
Language:English
Subjects:
Appendectomy
Appendicitis
Appendix
Colonoscopy
Cysts
Data processing
Hyperplasia
Laparoscopy
Malignancy
Mucin
Mucoceles
Mucosa
Neoplasms
Pathology
Patients
Retention
Surgery
Systematic review
Tumors
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Summary:Appendiceal mucoceles (AMs) are rare mucin-containing neoplasms with malignant potential. Lack of evidence-based data exists defining clinicopathological features for management. MEDLINE search between 1995 and 2015 was performed using search criteria “Appendix mucocele.” Systematic review of patient-, pathologic-, and treatment-related characteristics was performed and data analyzed. Among 276 cases of non-perforated AMs, 163 (59%) patients were female, with variable and nonspecific presentation. Patients were treated with appendectomy (52.1%), right hemicolectomy (17.6%), partial cecectomy (17.2%), and ileocecetomy (13.1%). Pathologic evaluation revealed the following: cystadenoma/low-grade appendiceal mucinous neoplasm (54%), unspecified/benign (25%), retention cyst (14.1%), cystadenocarcinoma (4.2%), and mucosal hyperplasia (2.9%). All 11 (4.2%) patients with cystadenocarcinoma were female (P = 0.004), odds ratio for malignancy 1.07 times higher for women. Synchronous colonic malignancy was reported in three patients (27%) with cystadenocarcinoma (P = 0.007), odds ratio of 12.1. AMs have low risk for malignancy. Treatment should begin with appendectomy-only and subsequently guided by pathologic diagnosis.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481808400237