SECTION EDITOR: CARL E. BREDENBERG, MD
Author Affiliations: Department of Surgery, Tulane University, New Orleans, Louisiana.
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.
Figure 1. Magnetic resonance image of the abdomen showing cystic mass superior to the bladder.
Figure 2. The operative specimen.
A. Mucinous cystadenocarcinoma
B. Mesenteric cyst
C. Low-grade appendiceal mucinous neoplasm
Crichlow L, Jaffe BM, Bellows CF. Image of the Month—Quiz Case. Arch Surg. 2012;147(8):781. doi:10.1001/archsurg.2011.963