Appendiceal mucocele. Contraindication to laparoscopic appendectomy. 1998

S González Moreno, and B M Shmookler, and P H Sugarbaker
Washington Cancer Institute, 110 Irving Street NW, Washington, DC 20010, USA.

Indications and contraindications to laparoscopic surgery continue to be refined. Laparoscopic appendectomy for acute appendicitis is frequently selected by patients and surgeons, and clinical studies show it to be a reasonable alternative. In this case study, laparoscopic surgery was used to resect an appendiceal mucocele caused by a nonperforated mucinous adenocarcinoma. Implants of mucinous tumor were found widely disseminated on peritoneal surfaces at laparotomy 9 months later. As a result of this case study, the authors suggest that when an appendiceal mucinous tumor is encountered at laparoscopy, a special situation requiring totally atraumatic appendectomy is indicated. This clinical situation should be considered an indication for conversion to open appendectomy. All appendiceal tumors, including the most benign-appearing adenomas, can result in diffuse peritoneal implantation. This is the first report of an appendiceal mucinous tumor resected by laparoscopy associated with subsequent diffuse peritoneal carcinomatosis. This patient presentation reaffirms that dissemination of cancer may be associated with laparoscopic resection of structures containing a malignancy.

UI MeSH Term Description Entries
D009078 Mucocele A retention cyst of the salivary gland, lacrimal sac, paranasal sinuses, appendix, or gallbladder. (Stedman, 26th ed) Mucoceles
D009366 Neoplasm Seeding The local implantation of tumor cells by contamination of instruments and surgical equipment during and after surgical resection, resulting in local growth of the cells and tumor formation. Seeding, Neoplasm
D010535 Laparoscopy A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy. Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D002288 Adenocarcinoma, Mucinous An adenocarcinoma producing mucin in significant amounts. (From Dorland, 27th ed) Carcinoma, Colloid,Carcinoma, Mucinous,Adenocarcinomas, Mucinous,Carcinomas, Colloid,Carcinomas, Mucinous,Colloid Carcinoma,Colloid Carcinomas,Mucinous Adenocarcinoma,Mucinous Adenocarcinomas,Mucinous Carcinoma,Mucinous Carcinomas
D002429 Cecal Diseases Pathological developments in the CECUM. Cecal Disease,Disease, Cecal,Diseases, Cecal
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000075202 Contraindications A condition or factor associated with a recipient that makes the use of a drug, procedure, or physical agent improper or inadvisable. Contraindications may be absolute (life threatening) or relative (higher risk of complications in which benefits may outweigh risks). Contraindications, Physical Agent,Medical Contraindications,Agent Contraindication, Physical,Agent Contraindications, Physical,Contraindication,Contraindication, Medical,Contraindication, Physical Agent,Contraindications, Medical,Medical Contraindication,Physical Agent Contraindication,Physical Agent Contraindications
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001062 Appendectomy Surgical removal of the vermiform appendix. (Dorland, 28th ed) Appendectomies

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