Duplicated Appendix With Mucocele Mimicking an Appendiceal Neoplasm in a 45-Year-Old Woman: A Case Report.
Olayinka Lukman Adewunmi, Gaurav Garg, Suvendu Sekhar Jena et al.
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Case in brief
A 45-year-old woman with right lower-quadrant pain and fever had CT evidence of ruptured appendicitis with a loculated peri-appendiceal abscess, which improved after percutaneous drainage and intravenous antibiotics. Two months later, recurrent pain prompted laparoscopy, where a firm, dilated appendiceal tip and an inflammatory ileocecal mass raised concern for malignancy. Right hemicolectomy was performed because the anatomy was distorted and neoplasm could not be excluded. Histopathology showed a Type B2 (Cave-Wallbridge) duplicated appendix, with mucocele formation and resolving appendicitis in one appendix; no malignancy was found.
What made this case unusual
The duplicated appendix was associated with a mucocele and presented as a mass-like inflammatory complex suspicious for neoplasm, with the diagnosis established only on histopathology.
Diagnostic / clinical pearl
When appendiceal or ileocecal anatomy is distorted, duplication may be difficult to recognize before or during surgery; careful intraoperative assessment and histopathology can identify otherwise missed pathology.