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OpenAthens Shibboleth
Special Feature
August 2012

Image of the Month—Quiz Case

Author Affiliations


Author Affiliations: Department of Surgery, Tulane University, New Orleans, Louisiana.

Arch Surg. 2012;147(8):781. doi:10.1001/archsurg.2011.963

A 52-year-old man came to the clinic with occasional dysuria, urinary frequency, and nonspecific abdominal pain lasting 5 months. His medical history included alcohol abuse/dependence and hypertension. On physical examination, his abdomen was soft, nontender, and nondistended, with no palpable masses. An abdominal ultrasound identified a cystic mass in his pelvis. Magnetic resonance imaging of the abdomen and pelvis revealed a large cystic mass measuring 7.5 × 5.7 × 6.0 cm in the right lower quadrant of the abdomen (Figure 1). At elective exploratory laparotomy, a mass at the tip of the appendix was identified (Figure 2). The patient's postoperative course was uncomplicated, and he was discharged home on postoperative day 5.

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Figure 1. Magnetic resonance image of the abdomen showing cystic mass superior to the bladder.

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Figure 2. The operative specimen.

What Is the Diagnosis?

A.  Mucinous cystadenocarcinoma

B.  Mesenteric cyst

C.  Low-grade appendiceal mucinous neoplasm

D.  Carcinoid