Abdominal hernia and the unexpected final diagnosis

Abstract

Mucinous neoplasm of the appendix are rare entities, among these, mucinous cystadenomas contribute to 31-34%. Cystadenomas often produce extensive dilatation of the appendix with epithelial atypia. Spontaneous perforation often occurs in 20%, leading to mucin distribution throughout the peritoneal cavity. Half of the patients are completely asymptomatic and are detected as an incidental diagnosis, others symptoms include a palpable mass, hernias, weight loss, peritonism or even intestinal obstruction. We present a case of a 71-year-old female, she presented with a palpable mass in the upper abdomen. A ventral hernia was the most likely diagnosis and hernioplasty was planned. At surgery, a mucinous mass was discovered and mucous material was found free en the peritoneal cavity. Also, a perforated appendix and a mass in the cecum was found. Patient underwent full recovery. Pathology reported pseudomyxoma peritonei as the final diagnosis.