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DOI: 10.1148/rg.272065134
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Giant Mucinous Cystadenoma of the Appendix1

Thara Persaud, MB, Niall Swan, MB and William C. Torreggiani, MB

1 From the Department of Radiology, Adelaide and Meath Incorporating the National Children’s Hospital, Tallaght, Dublin 24, Ireland. Received July 13, 2006; revision requested August 16 and received September 26; accepted September 29. All authors have no financial relationships to disclose.

Figure 1
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  		Figure 1.  Axial pelvic CT scan obtained with both oral and intravenous contrast agents depicts a 17-cm tubular mass that extends across the pelvis and that contains a central area of cystic change and peripheral wall calcifications. The mass is attached to the cecum on the right side and, on the left, compresses the left external iliac vein.

 

Figure 2
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  		Figure 2.  Axial T1-weighted MR image shows the mass with uniform low signal intensity and with a clear connection to the cecum (black arrow). The cecum (* appears normal. A high-signal-intensity thrombus (white arrow) due to compression of the left external iliac vein by the mass also is visible.

 

Figure 3
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  		Figure 3.  Axial T2-weighted MR image shows uniform high signal intensity at the center of the mass, with low signal intensity indicative of calcification in the thickened walls of the mass. The connection between the mass and the cecum is clearly visible, as is the compression of the left external iliac vein by the mass. (Fig 3 reprinted, with permission, from reference 1.)

 

Figure 4
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  		Figure 4.  Photograph shows the gross pathologic specimen obtained with a limited right hemicolectomy. The cecal wall appears thickened, and white plaque has accumulated on its external surface. (Reprinted, with permission, from reference 1.)

 

Figure 5
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  		Figure 5.  Transection of the gross specimen shows the appendiceal lumen filled with mucoid material, some of which is calcified, but no focal mass. The mass is clearly localized to the appendix, and the adjoining cecum is normal.

 

Figure 6A
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  		Figure 6a.  (a) Photomicrograph (original magnification, x400; hematoxylin-eosin stain) shows low-grade dysplasia of the neoplastic adenomatous epithelium that lines the distal part of the appendix (arrowhead). (b) Photomicrograph (original magnification, x40; hematoxylin-eosin stain) shows that the neoplastic epithelium consists of a single layer or pseudostratified layer with micropapillary projections (arrow). The abnormal epithelium was confined to the appendiceal lumen and did not extend through the wall.

 

Figure 6B
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  		Figure 6b.  (a) Photomicrograph (original magnification, x400; hematoxylin-eosin stain) shows low-grade dysplasia of the neoplastic adenomatous epithelium that lines the distal part of the appendix (arrowhead). (b) Photomicrograph (original magnification, x40; hematoxylin-eosin stain) shows that the neoplastic epithelium consists of a single layer or pseudostratified layer with micropapillary projections (arrow). The abnormal epithelium was con-fined to the appendiceal lumen and did not extend through the wall.

 




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