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Year : 2019  |  Volume : 5  |  Issue : 2  |  Page : 187-189

Appendicular lump misdiagnosed as ovarian tumor

1 Senior Resident, Dept. of Gynecological oncology, IGIMS, Patna, Bihar, India
2 PG Student, Department of general surgery, JLNMC, Bhagalpur, India
3 Professor & Head, Dept. of Gynecological oncology, IGIMS, Patna, Bihar, India

Correspondence Address:
Sangeeta Pankaj
Professor & Head, Gynecological Oncology, IGIMS, Patna
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Source of Support: None, Conflict of Interest: None

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Appendiceal mucocele is a rare entity which occurs due to cystic dilatation because of abnormal accumulation of mucus in the lumen of the appendix. Patients are often diagnosed incidentally during abdominal surgery for other causes. When the patient is symptomatic,the most common symptom of appendix mucocele is pain in the right lower quadrant of the abdomen. Mucocele may present as acute or chronic appendicitis. This is a study done on a 52-year-old female for whom surgical intervention for ovarian tumor was planned, but who instead underwent laparotomy for appendicular lump. Radiologic assessments showed large sized right adenexal cystic lesion with mild enhancing wall thickening infero-medially. The test for serum tumor markers showed normal level of CA-125. The patient underwent a laparotomy and appendicular lump was found. We conducted frozen section biopsy of mass for confirming malignancy before performing staging surgery. The result of frozen section biopsy confirmed appendicular lump. Subsequently total hysterectomy and B/L salpingo-oopherectomy were performed. Appendicular Mass was removed. It should be taken into consideration that the possibility of malignancy is low in post menopausal woman with normal CA-125 Level. Instead of performing staging surgery,it is appropriate to carry out surgery based on result of intra-operative frozen section biopsy so that we were able to avoid unnecessary surgical procedures. Gynecologists should routinely consider this disease in the differential diagnosis of right lower dumbbell abdominal cysts. Eleven percent to 20% of mucoceles are caused by mucinous cystadenocarcinomas.

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