The designation of mucocele has been traditionally applied to a group of appendiceal
lesions characterized by one or more of the following features ; (1) dilatation of the
lumen, (2) alterations of the mucosal lining, (3) hypersecretion of mucus, and (4)
occasional extension outside the appendix, either as peritoneal implants or exceptionally
as distant metastatic spread.
The re-evaluation of 7 appenaiceal mucoceles, examined at Department of Pathology,
National Medical Center, Seoul, during 17 years from March 1959 to July 1976, was
made and showed four distinctive clinicopathologic entities :
1) Secondary mucosal atrophy resulting from proximal luminal obliteration (1 case),
accomp-anied with volvulus.
2) Focal mucosal hyperplasia (1 case), with no epithelial atypia. This case was
associated with mucinous adenocarcinoma of cecum.
3) Mucinous cystadenoma (4 cases). Two of these reveal slight degree of cellular
atypia and some acellular mucus in peritoneal cavity without adhesion. Remaining
two show mucosal ulceration of appendico-cecal junction.
4) Mucinous cystadenocarcinoma (1 case). This case shows focal stromal invasion by
atypical glands and/or epithelial cells, also seen in peritoneal implants.
On the basis of these findings, most instances of so-called mucocele should be
regarded as mucinous neoplasms, analogous in many aspects to the epithelial tumors of
the colon, and those diagnostic distinction is justified on practical grounds, since it
provides the pathologist and the surgeon with definite criteria on which base prognostic
and therapeutic consideration.
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