A Rare Tumor Resembling Ovarian Cysts: Mucocele of the Appendix


  • C.M. Ortiz-Mendoza Department of Surgical Oncology, Hospital General “Tacuba”, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE: State´s Employees´ Social Security and Social Services Institute). Mexico City, Mexico
  • A. Catarino-Dircio Department of Pathology, Hospital General “Tacuba”, ISSSTE. Mexico City, Mexico




Diagnosis/Differential, Female, Humans, Middle Aged, Mucocele/diagnosis, Ovarian Cysts/diagnosis.


Objective: To show unusual presentation of a rare disease that may lead to a diagnosis mistake.

Case report: A 46-year-old postmenopausal woman went to her family physician due to a six-month abdominal pain on her right iliac-fossa. Her physical exam was normal, but a pelvic transabdominal ultrasonography showed a 12-cm left ovarian-cyst. Therefore, their doctor sent her to gynecology service, where the work-up indicated a benign cyst. Thus, they scheduled an oophorectomy. During surgery, through a Pfannenstiel incision, uterus and ovaries were normal, but the "cyst" was a tumor of the appendix, so their gynecologists consulted to surgical oncology. The tumor (12-cm) was gray, firm, with smooth surface, and completely adherent to cecum. We diagnosed a tumor of the appendix and carried-out a different surgical incision and a right hemicolectomy. She had an uneventful postoperative course, and the pathologist diagnosed a mucocele of the appendix.

Conclusion: The mucocele of the appendix may be confused with ovarian cysts on ultrasonography.


Stany MP, Hamilton CA. Benign disorders of the ovary. Obstet Gynecol Clin North Am 2008; 35(2): 271-84. http://dx.doi.org/10.1016/j.ogc.2008.03.004

Solnik MJ, Alexander C. Ovarian incidentaloma. Best Pract Res Clin Endocrinol Metab 2012; 26(1): 105-16. http://dx.doi.org/10.1016/j.beem.2011.07.002

Valentin L, Ameye L, Franchi D, Guerriero S, Jurkovic D, Savelli L, et al. Risk of malignancy in unilocular cysts: a study of 1148 adnexal masses classified as unilocular cysts at transvaginal ultrasound and review of the literature. Ultrasound Obstet Gynecol 2013; 41(1): 80-9. http://dx.doi.org/10.1002/uog.12308

Lin JY, Angel C, DuBeshter B, Walsh CJ. Diagnoses after laparotomy for a mass in the pelvic area in women. Surg Gynecol Obstet 1993; 176: 333-8.

Benoit MF, Hannigan EV, Smith RP, Smith ER, Byers LJ. Primary gastrointestinal cancers presenting as gynecologic malignancies. Gynecol Oncol 2004; 95: 388-92. http://dx.doi.org/10.1016/j.ygyno.2004.07.032

Moran B, Baratti D, Yan TD, Kusamura S, Deraco M. Consensus statement on the loco-regional treatment of appendiceal mucinous neoplasms with peritoneal dissemination (pseudomyxoma peritonei). J Surg Oncol 2008; 98: 277-82. http://dx.doi.org/10.1002/jso.21054

Pickhardt PJ, Levy AD, Rohrmann CA Jr, Kende AI. Primary neoplasms of the appendix: radiologic spectrum of disease with pathologic correlation. Radiographics 2003; 23: 645-62. http://dx.doi.org/10.1148/rg.233025134

Vavilis D, Athanatos D, Tsolakidis D, Papanicolaou A, Bontis JN. Mucocele of the appendix mimicking an adnexal mass: a case report. Clin Exp Obstet Gynecol 2009; 36: 135-6.

Balci O, Ozdemir S, Mahmoud AS. Appendiceal mucocele mimicking a cystic right adnexal mass. Taiwan J Obstet Gynecol 2009; 48: 412-4. http://dx.doi.org/10.1016/S1028-4559(09)60333-8

Papoutsis D, Protopappas A, Belitsos P, Sotiropoulou M, Antonakou A, Loutradis D, et al. Mucocele of the vermiform A Rare Tumor Resembling Ovarian Cysts appendix misdiagnosed as an adnexal mass on transvaginal sonography. J Clin Ultrasound 2012; 40: 522-5. http://dx.doi.org/10.1002/jcu.20858

Shankar S, Ledakis P, El Halabi H, Gushchin V, Sardi A. Neoplasm of the appendix: current treatment guidelines. Hematol Oncol Clin North Am 2012; 26: 1261-90. http://dx.doi.org/10.1016/j.hoc.2012.08.010