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Case Report Open Access

Appendiceal mucinous tumour resulting in autoamputation of the appendix: A case report and literature review

  • Authors:
    • Chenao Wang
    • Yufeng Liu
    • Yaqing Liu
    • Baicheng Li
    • Xingdong Hou
    • Bowei Lu
    • Zhao Chen
    • Shili Ning
  • View Affiliations / Copyright

    Affiliations: Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116023, P.R. China
    Copyright: © Wang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 48
    |
    Published online on: December 5, 2025
       https://doi.org/10.3892/etm.2025.13043
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Abstract

Appendiceal mucinous tumours are rare and can cause various complications, but to the best of our knowledge, there have been no reports of cases leading to secondary appendiceal autoamputation. Appendiceal autoamputation is the detachment of part of the appendix without surgery or other invasive interventions and is rarely observed in clinical settings. The present study reports the case of a 68‑year‑old male patient who was admitted to the hospital due to right lower abdominal pain and was consequently diagnosed with a periappendiceal abscess and underwent conservative anti‑inflammatory drug treatment, which successfully improved the condition of the patient. Laparoscopic appendectomy was conducted 3 months later, during which the appendix was found to have partially separated; postoperative pathology revealed an appendiceal mucinous tumour. Following pathological confirmation of the diagnosis, right hemicolectomy, resection of the greater omentum and partial peritoneal resection were performed, followed by hyperthermic intraperitoneal chemotherapy in accordance with current treatment guidelines. The patient recovered well and was discharged following the operation. Considering the condition of the patient, appendiceal autoamputation was thought to be caused by the appendiceal mucinous tumour. The present case highlights the diagnostic challenges of appendiceal mucinous tumours and underscores the early standardized treatment to improve prognosis.
View Figures

Figure 1

Abdomen CT and ultrasound examination,
March 2023. (A) CT image showing oozing effusive changes in the
iliac fossa area of the ileocecal region with adhesions to the
adjacent bowel (red circle). (B) First ultrasound examination
revealed disturbed intestinal echoes in the right lower abdominal
region, mixed echoes were observed next to the iliac vessels,
measuring ~6.5x5.3 cm, with tubular echoes, with a blind end on one
side, and 1.6 cm at the widest point. Ultrasound suggested
periappendiceal inflammatory wrapping. (C) Repeat ultrasound
revealed mixed echoes in the iliac paravalves that were smaller
than the previous echoes, measuring ~5.3x2.9 cm. m, m-type
ultrasound mode.

Figure 2

Abdomen CT, laparoscopic and
extracorporeal appendix images. (A) CT image of the appendix, June
2023. (B) Laparoscopic view of the appendix, ~6.5 cm long
(including the distance from the point of dissection) and ~5 mm in
diameter. Proximal appendix (arrow 1); medial appendicular artery
of the mesentery (arrow 2); distal appendix (arrow 3). (C) Gross
specimen of the resected appendix. Proximal appendix (arrow 1);
appendicular artery (arrow 2); distal appendix (arrow 3).

Figure 3

Microscopic pathology slides, images
of peritoneal lavage fluid and resected intestinal tubes. (A and B)
Haematoxylin and eosin demonstrating the disappearance of the
lamina propria of the appendiceal mucosa, mucosal epithelial
hyperplasia and the absence of mucus components and epithelial
cells in the muscular and plasma layers were consistent with a
low-grade appendiceal mucinous tumour at magnifications of (A) x4
and (B) x10. (C) Layering of the peritoneal lavage fluid; clear
light red turbid mucus in the upper layer and dark red lavage fluid
in the lower layer.

Figure 4

Gross specimen of the right colon and
pathological sections of the intestinal margin. (A) Large specimen
of the resected right hemicolon. (B) No neoplastic/diseased tissue
was identified at the ileocecal resection margin. (C) No
neoplastic/diseased tissue was identified at the lateral resection
margin of the colon. (D) No pathological/diseased tissue was
identified in the perienteric soft tissue or the surrounding
adipose tissue.

Figure 5

Immunohistochemical markers in the
removed appendix tissue. (A) CKpan positivity; (B) CK7 negativity;
(C) CK20 positivity; (D) caudal type homeobox 2 positivity; (E)
MUC2 positivity; (F) MUC5AC negativity; (G) PAX-2 negativity; (H)
PAX-8 negativity; and (I) Ki-67 negativity. CK, cytokeratin; PAX,
paired box; MUC, mucin.

Figure 6

CT examination results of the 3
patients within 1 year of the operation did not reveal any imaging
signs of disease progression or recurrence. The highlighted linear
shadows in the images represent the nails of the intestinal
stapler. Continuous CT images show the conditions around the
intestinal anastomosis. (A-C) The CT examination performed in
August 2023. (D-F) The CT examination performed in February 2024.
(G-I) The CT examination performed in June 2024.
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Copy and paste a formatted citation
Spandidos Publications style
Wang C, Liu Y, Liu Y, Li B, Hou X, Lu B, Chen Z and Ning S: Appendiceal mucinous tumour resulting in autoamputation of the appendix: A case report and literature review. Exp Ther Med 31: 48, 2026.
APA
Wang, C., Liu, Y., Liu, Y., Li, B., Hou, X., Lu, B. ... Ning, S. (2026). Appendiceal mucinous tumour resulting in autoamputation of the appendix: A case report and literature review. Experimental and Therapeutic Medicine, 31, 48. https://doi.org/10.3892/etm.2025.13043
MLA
Wang, C., Liu, Y., Liu, Y., Li, B., Hou, X., Lu, B., Chen, Z., Ning, S."Appendiceal mucinous tumour resulting in autoamputation of the appendix: A case report and literature review". Experimental and Therapeutic Medicine 31.2 (2026): 48.
Chicago
Wang, C., Liu, Y., Liu, Y., Li, B., Hou, X., Lu, B., Chen, Z., Ning, S."Appendiceal mucinous tumour resulting in autoamputation of the appendix: A case report and literature review". Experimental and Therapeutic Medicine 31, no. 2 (2026): 48. https://doi.org/10.3892/etm.2025.13043
Copy and paste a formatted citation
x
Spandidos Publications style
Wang C, Liu Y, Liu Y, Li B, Hou X, Lu B, Chen Z and Ning S: Appendiceal mucinous tumour resulting in autoamputation of the appendix: A case report and literature review. Exp Ther Med 31: 48, 2026.
APA
Wang, C., Liu, Y., Liu, Y., Li, B., Hou, X., Lu, B. ... Ning, S. (2026). Appendiceal mucinous tumour resulting in autoamputation of the appendix: A case report and literature review. Experimental and Therapeutic Medicine, 31, 48. https://doi.org/10.3892/etm.2025.13043
MLA
Wang, C., Liu, Y., Liu, Y., Li, B., Hou, X., Lu, B., Chen, Z., Ning, S."Appendiceal mucinous tumour resulting in autoamputation of the appendix: A case report and literature review". Experimental and Therapeutic Medicine 31.2 (2026): 48.
Chicago
Wang, C., Liu, Y., Liu, Y., Li, B., Hou, X., Lu, B., Chen, Z., Ning, S."Appendiceal mucinous tumour resulting in autoamputation of the appendix: A case report and literature review". Experimental and Therapeutic Medicine 31, no. 2 (2026): 48. https://doi.org/10.3892/etm.2025.13043
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