Low-grade Appendiceal Mucinous Neoplasm (LAMN): Description of an uncommon entity by Babatope Lanre Awosusi in Journal of Clinical Case Reports Medical Images and Health Sciences

 Low-grade Appendiceal Mucinous Neoplasm (LAMN): Description of an uncommon entity by Babatope Lanre Awosusi in Journal of Clinical Case Reports Medical Images and Health Sciences

Background: Low-grade appendiceal mucinous neoplasm (LAMN) is an uncommon tumor of the appendix with attendant risk of serious complications.1 It can present with abdominal pain and distention, vomiting, a palpable mass, intestinal obstruction, weight loss, and sometimes intussusception. Other uncommon forms of presentation include hematuria, ureteral obstruction, hydronephrosis, and urinary tract infection.1

Case presentation: A 47-year-old female presented with three days of constant dull right upper and lower quadrant abdominal pain associated with nausea, vomiting, and bloating. She had a similar episode two months prior with intermittent right lower quadrant pain, nausea, and vomiting for two days. There was associated low-grade fever. On examination, she had mild tenderness in the right lower quadrant with no guarding or rebound tenderness. Laboratory investigations showed only leukocytosis. Computed tomography scan of the abdomen done revealed a dilated fluid-filled appendix measuring 1.8 cm in diameter. Laparoscopic appendectomy was done and histopathological examination of the specimen showed features consistent with a low-grade mucinous neoplasm of the appendix with acellular mucin dissecting the muscularis and serosa. Histology did not show peritoneal spread but patient still had post-operative clinical and radiologic follow-up with no adverse event reported.

Conclusion: Low-grade appendiceal mucinous neoplasms are lesions of the appendix that can rupture and lead to pseudomyxoma peritonei with risk of mortality. If it is confined to the appendix, surgical management will suffice with clinical follow-up and imaging if the margins involve acellular mucin or neoplastic epitheli.

For more information JCRMHS

Comments

Post a Comment

Popular posts from this blog

Clinical Case Reports – 1970 by P. Syamasundar Rao in Journal of Clinical Case Reports Medical Images and Health Sciences

 Clinical Case Reports – 1970 by P. Syamasundar Rao in Journal of Clinical Case Reports Medical Images and Health Sciences Abstract In this paper five case reports were presented and include congenital pulmonary cyst, Wilson-Mikity syndrome, diaphragmatic eventration; foreign body in the bronchus, and cor pulmonale that developed after implantation of a ventriculo-atrial shunt with a Pudenz-Heyer valve for treatment of hydrocephalus. For each case report, clinical, chest x-ray, electrocardiogram and other pertinent findings were presented. This was followed by discussion of etiology, diagnosis, and treatment options, as appropriate. Keywords:  congenital pulmonary cyst; diaphragmatic eventration; Wilson-Mikity syndrome; foreign body in the bronchus; cor pulmonale Introduction During the academic clinical practice for over five decades, the author had the unique opportunity to observe and document many interesting clinical case scenarios. The purpose of this review is to rev...
Read more

Covid-19 associated autoimmune encephalitis in Iraq. A Case Report by Faiq B. Basa in Journal of Clinical Case Reports Medical Images and Health Sciences

 Covid-19 associated autoimmune encephalitis in Iraq. A Case Report by Faiq B. Basa in Journal of Clinical Case Reports Medical Images and Health Sciences Abstract Covid-19 infection frequently causes neurological symptoms. One of the mechanisms of indirect nervous system involvement is through inflammatory response and immune dysregulation. There are few recorded cases of indirect involvement of CNS by auto-antibodies. We present a case of a 6-year-old Iraqi boy with anti–N-methyl-d-aspartate receptor (anti-NMDAR) autoimmune encephalitis, associated with Covid-19. He presented with recent repeated attacks of refractory focal seizures preceded by behavioral changes. Serum and CSF anti-NMDAR antibodies were positive. Early recognition and treatment of autoimmune encephalitis are crucial as the prognosis is promising with early immunotherapy. Autoimmune encephalitis should be included in the main differential diagnosis whenever refractory epilepsy or new onset status epilepticus is...
Read more

Atypical Mycobacteria Infection Mimicking Cutaneous Sarcoidosis by Dr Rishi Agrawal in Journal of Clinical Case Reports Medical Images and Health Sciences

 Atypical Mycobacteria Infection Mimicking Cutaneous Sarcoidosis by Dr Rishi Agrawal in Journal of Clinical Case Reports Medical Images and Health Sciences A 51 year-old male presented with a 2-week history of a firm and tender suprapubic lump. The patient denied constitutional symptoms. His medical history was significant for sarcoidosis. He was referred to a penile surgeon, the main clinical concern being that of malignancy. MRI scanning revealed a 2.9cm encapsulated subcutaneous soft tissue mass separate from the penis. The pelvis and penis were unremarkable. Microscopy from an US-guided biopsy revealed relatively ill-defined granulomatous inflammation with abundant admixed acute and chronic inflammatory cell infiltrate (Figures 1A-C). No necrosis or malignancy was seen Special stains revealed conspicuous acid-fast bacilli, with no fungal elements identified (Figure 1D). Subsequent polymerase chain reaction (PCR) testing confirmed the presence of Mycobacterium avium (M. avium...
Read more