Mucinous cystadenocarcinoma of the appendix in which contrast‑enhanced ultrasonography was useful for assessing blood flow in a focal nodular lesion in the tumor cavity: A case report

Wakui,Noritaka; Fujita,Mitsuru; Yamauchi,Yoshiya; Takeda,Yuki; Ueki,Nobuo; Otsuka,Takafumi; Oba,Nobuyuki; Nishinakagawa,Shuta; Takezoe,Toshiko; Hiroyoshi,Junko; Kono,Yoshiharu; Katahira,Seiichiro; Minagawa,Masami; Takeda,Yasushi; Shiono,Saori; Kojima,Tatsuya

doi:10.3892/etm.2013.1094

Mucinous cystadenocarcinoma of the appendix in which contrast‑enhanced ultrasonography was useful for assessing blood flow in a focal nodular lesion in the tumor cavity: A case report

Authors:
- Noritaka Wakui
- Mitsuru Fujita
- Yoshiya Yamauchi
- Yuki Takeda
- Nobuo Ueki
- Takafumi Otsuka
- Nobuyuki Oba
- Shuta Nishinakagawa
- Toshiko Takezoe
- Junko Hiroyoshi
- Yoshiharu Kono
- Seiichiro Katahira
- Masami Minagawa
- Yasushi Takeda
- Saori Shiono
- Tatsuya Kojima
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Affiliations: Department of Internal Gastroenterology and Hepatology, Tokyo Rosai Hospital, Tokyo 143-0013, Japan, Department of Surgery, Tokyo Rosai Hospital, Tokyo 143-0013, Japan, Department of Pathology, Tokyo Rosai Hospital, Tokyo 143-0013, Japan
Published online on: April 30, 2013 https://doi.org/10.3892/etm.2013.1094
Pages: 3-8

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Abstract

A 63-year-old woman was admitted to hospital with pain in the right lower quadrant. Abdominal computed tomography (CT) revealed a 60-mm cystic mass at a site corresponding to the appendix. The mass wall on the appendicular ostium was thickened and enhanced by contrast, while calcification was observed in the mass wall on the appendicular tip. No projection was observed in the mass cavity. On abdominal ultrasonography (US), the mass wall on the appendicular ostium was thickened and projections were observed at two sites in the mass cavity. On contrast‑enhanced US (CEUS), only one of these projections was enhanced. Based on the thickened and contrast-enhanced wall of the mass on the appendicular ostium on CT and US, as well as the contrast enhancement of a projection on US, the mass was diagnosed as mucinous cystadenocarcinoma of the appendix. Ileocecal resection was subsequently performed on day 10. A detailed examination of the surgical specimen revealed carcinoma cells in the mass wall on the appendicular ostium. The contrast‑enhanced projection was identified as granulation tissue that had grown to come into contact with the tumor, while the non‑contrast-enhanced projection was identified as solidified mucus. US enabled successful visualization of projections in the mass cavity that were not visible on abdominal CT. CEUS also proved useful for assessing blood flow in these projections.

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