Snapshot quiz 12/5

Published: 06/28/2012

Authors: Ahmad M, Desai A and Gourevitch D

This 67 year-old man had a scan of the abdomen as part of a routine health check. It showed an incidental 20 x 12 cm cystic mass in the retroperitoneum. At laparotomy, the mass was found to be arising from the appendix. An appendicectomy with en bloc excision of the mass was undertaken, taking care not to breach the capsule. The specimen contained thick, gelatinous material and microscopic examination revealed it to be a low-grade mucinous neoplasm of the appendix. Dissemination of such neoplasms, either by spontaneous or intra-operative rupture, can result in pseudomyxoma peritonei, a rare relapsing disease characterised by mucinous ascites.