{"paper_id":"c23eaa9a-d376-450a-a83e-d3395968e39f","body_text":"Abstract\nWe report a rare case of a mucocele of the appendix due to endometriosis which accidentally ruptured prior to surgery. A 56-year-old woman was referred to our institution for further evaluation of a cecal tumor. Colonoscopy showed a submucosal tumor at the appendiceal orifice in the cecum. Computed tomography and magnetic resonance imaging showed a well-circumscribed mass measuring 4 cm in diameter in the right lower quadrant. A preoperative diagnosis of a simple mucocele of the appendix was established. At laparotomy, a mucocele was identified in the right side of the abdomen; however, part of the mucocele had ruptured and yellow mucin was seen around the cecum. An ileocecal resection was performed. Histopathological examination was consistent with a mucocele of the appendix due to endometriosis. Cytology specimens from the yellow mucin showed few proliferating epithelial cells with a mild degree of cytological and architectural atypia. Mechanical pressure due to excess anteflexion during administration of epidural anesthesia may have contributed to the rupture of the mucocele. It is important to handle a mucocele of the appendix with great care to avoid rupture at the time of operation, including during the administration of epidural anesthesia.\nSimilar content being viewed by others\nReferences\nWoodruff R, McDonald J. Benign and malignant cystic tumors of the appendix. Surg Gynecol Obstet. 1940;71:751–5.\nDhage-Ivatury S, Sugarbaker PH. Update on the surgical approach to mucocele of the appendix. J Am Coll Surg. 2006;202:680–4.\nHapke MR, Bigelow B. Mucocele of the appendix secondary to obstruction by endometriosis. Hum Pathol. 1977;8:585–9.\nUohara JK, Kobara TY. Endometriosis of the appendix. Am J Obstet Gynecol. 1975;121:423–6.\nDriman DK, Melega DE, Vilos GA, Plewes EA. Mucocele of the appendix secondary to endometriosis: report of two cases, one with localized pseudomyxoma peritonei. Am J Clin Pathol. 2000;113:860–4.\nKimura H, Konishi K, Yabushita K, Maeda K, Tsuji M, Miwa A. Intussusception of a mucocele of the appendix secondary to an obstruction by endometriosis. Surg Today. 1999;29:629–32.\nNopajaroonsri C, Mreyoud N. Retention mucocele of appendix due to endometriosis. South Med J. 1994;87:833–5.\nO’Sullivan MJ, Kumar U, Kiely EA. Ureteric obstruction with mucocoele of the appendix due to endometriosis. BJOG. 2001;108:124–5.\nAbrao MS, Podgaec S, Carvalho FM, Gonçalves MO, Dias JA Jr, Averbach M. Bowel endometriosis and mucocele of the appendix. J Minim Invasive Gynecol. 2005;12:299–300.\nHamiliton D, Stormont J. The volcano sign of appendiceal mucocele. Gastrointest Endosc. 1989;35:453–5.\nKoga H, Aoyagi K, Honda H, Fujishima M. Appendiceal mucocele: sonographic and MR imaging findings. Am J Roentgenol. 1995;165:1552.\nRampone B, Roviello F, Marrelli D, Pinto E. Giant appendiceal mucocele: report of a case and brief review. World J Gastroenterol. 2005;11:4761–3.\nRonnett BM, Zahn CM, Kurman RJ, Kass ME, Sugarbaker PH, Shmookler BM. Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis. A clinicopathologic analysis of 109 cases with emphasis on distinguishing pathologic features, site of origin, prognosis, and relationship to “pseudomyxoma peritonei”. Am J Surg Pathol. 1995;19:1390–408.\nConflict of interest\nAll authors have no conflict of interest and also have no financial relationship with the organization that sponsored this research.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nMiyakura, Y., Kumano, H., Horie, H. et al. Rupture of appendiceal mucocele due to endometriosis: report of a case. Clin J Gastroenterol 5, 220–224 (2012). https://doi.org/10.1007/s12328-012-0302-9\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s12328-012-0302-9","source_license":"CC0","license_restricted":false}