Two cases of low-grade appendiceal mucinous neoplasm (LAMN) mimicking ovarian tumors successfully treated with laparoscopic surgery

We report two cases of low-grade appendiceal mucinous neoplasm (LAMN) mimicking ovarian tumors that were treated with laparoscopic surgery. Case 1: A 57-year-old woman was referred to our hospital because of a pelvic mass noted during physical examination. Imaging revealed an oval, cystic, 81×39-mm...

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Published inFUKUSHIMA JOURNAL OF MEDICAL SCIENCE p. 24-00051
Main Authors Anjo, Kazuki, Yazawa, Hiroyuki, Ojima, Tsukasa Sanpei, Yazawa, Riho, Inazuki, Akari
Format Journal Article
LanguageEnglish
Published Japan THE FUKUSHIMA SOCIETY OF MEDICAL SCIENCE 2025
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Abstract We report two cases of low-grade appendiceal mucinous neoplasm (LAMN) mimicking ovarian tumors that were treated with laparoscopic surgery. Case 1: A 57-year-old woman was referred to our hospital because of a pelvic mass noted during physical examination. Imaging revealed an oval, cystic, 81×39-mm mass diagnosed as a right ovarian tumor, and surgery was performed. Intraoperative findings revealed an appendiceal tumor, and laparoscopic appendectomy was conducted. The pathological diagnosis was LAMN.Case 2: A 76-year-old woman was referred to our hospital because of a pelvic mass noted during physical examination. Imaging revealed an oval, cystic, 36×23-mm mass in the pelvic cavity, which was suspected to be a right ovarian tumor. Since it was slightly displaced to the cephalic side, surgery was performed with the possibility of a gastrointestinal tumor in mind. Intraoperative findings revealed an appendiceal tumor, and a laparoscopic appendectomy was conducted. The pathological diagnosis was LAMN.LAMN is a rare lesion with a risk of serious complications if the appendiceal wall ruptures and the tumor extends beyond the appendix. Although its preoperative diagnosis is challenging, it is important that gynecologists differentiate it from adnexal tumors.
AbstractList We report two cases of low-grade appendiceal mucinous neoplasm (LAMN) mimicking ovarian tumors that were treated with laparoscopic surgery. Case 1: A 57-year-old woman was referred to our hospital because of a pelvic mass noted during physical examination. Imaging revealed an oval, cystic, 81×39-mm mass diagnosed as a right ovarian tumor, and surgery was performed. Intraoperative findings revealed an appendiceal tumor, and laparoscopic appendectomy was conducted. The pathological diagnosis was LAMN.Case 2: A 76-year-old woman was referred to our hospital because of a pelvic mass noted during physical examination. Imaging revealed an oval, cystic, 36×23-mm mass in the pelvic cavity, which was suspected to be a right ovarian tumor. Since it was slightly displaced to the cephalic side, surgery was performed with the possibility of a gastrointestinal tumor in mind. Intraoperative findings revealed an appendiceal tumor, and a laparoscopic appendectomy was conducted. The pathological diagnosis was LAMN.LAMN is a rare lesion with a risk of serious complications if the appendiceal wall ruptures and the tumor extends beyond the appendix. Although its preoperative diagnosis is challenging, it is important that gynecologists differentiate it from adnexal tumors.
ArticleNumber 24-00051
Author Ojima, Tsukasa Sanpei
Yazawa, Riho
Inazuki, Akari
Anjo, Kazuki
Yazawa, Hiroyuki
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  fullname: Anjo, Kazuki
  organization: Department of Obstetrics and Gynecology, Fukushima Medical University
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  fullname: Yazawa, Hiroyuki
  organization: Department of Obstetrics and Gynecology, Fukushima Red Cross Hospital
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  fullname: Ojima, Tsukasa Sanpei
  organization: Department of Obstetrics and Gynecology, Fukushima Red Cross Hospital
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  fullname: Yazawa, Riho
  organization: Department of Obstetrics and Gynecology, Ohta Nishinouchi Hospital
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  fullname: Inazuki, Akari
  organization: Department of Obstetrics and Gynecology, Fukushima Medical University
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Cites_doi 10.1007/s13193-020-01147-x
10.1097/DCR.0000000000001530
10.1245/s10434-019-07678-0
10.7759/cureus.28755
10.1002/jso.27304
10.7759/cureus.3980
10.1634/theoncologist.2017-0081
10.12998/wjcc.v9.i10.2334
10.1007/s00464-020-08046-w
10.1155/2021/5523736
10.5387/fms.2022-41
10.1007/s13193-016-0516-2
10.1097/DCR.0000000000001676
10.1136/jim-2018-000975
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Keywords low-grade appendiceal mucinous neoplasm (LAMN)
preoperative diagnosis
pseudomyxoma peritonei
laparoscopic surgery
ovarian tumor
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References 13. Yu XR, Mao J, Tang W, Meng XY, Tian Y, Du ZL. Low-grade appendiceal mucinous neoplasms confirmed to the appendix: clinical manifestations and CT findings. J Investig Med, 68: 75-81, 2020.
7. Rossi A, Patel NM. Appendiceal neoplasm-A practical guide. J Surg Oncol, 127: 1033-1305, 2023.
4. Shaib W, Assi R, Shamseddine A, et al. Appendiceal mucinous neoplasms: diagnosis and management. Oncologist, 22: 1107-1116, 2017.
17. Inoue A, Murata K, Komori T, et al. Open versus laparoscopic surgery for primary appendiceal tumors: a large multicenter retrospective propensity score-matched cohort study in Japan. Surg Endoc, 35: 5515-5523, 2021.
1. Misdraji J, Carr NL, Pai RK. Appendiceal mucinous neoplasm. In WHO Classification of Tumors of the Digestive System, 5th ed. IARC press, Lyon, pp. 144-146, 2019.
12. Yazawa R, Yazawa H, Fukuda K, Ohara M, Osuka F. Four cases of pseudomyxoma peritonei with ovarian tumors at our hospital. Fukushima J Med Sci, 2023.
15. Gonzalez HH, Herard K, Mijares MC. A rare case of low-grade appendiceal mucinous neoplasm: a case report. Cureus, 11: e3980, 2019.
16. Solomon D, Bekhor E, Leigh N, et al. Surveillance of low-grade appendiceal mucinous neoplasms with peritoneal metastases after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: are 5 years enough? a multisite experience. Ann Surg Oncol, 27: 147-153, 2020.
3. Ramaswamy V. Pathology of Mucinous Appendiceal Tumors and Pseudomyxoma Peritonei. Indian J Surg Oncol, 7(2): 258-267, 2016.
10. Borges AL, Reis-de-Carvalho C, Chorao M, Pereira H, Djokovic D. Low-grade mucinous appendiceal neoplasm mimicking an ovarian lesion: A case report and review of literature. World J Clin Cases, 9(10): 2334-2343, 2017.
11. Japanese Classification of Colorectal, Appendiceal, and Anal Carcinoma. 9th edition, Kanehara shuppan, Tokyo, p. 63-64, 2018.
5. Boshnaq M, Toeima M, Hamade A, Bagle N. Local protocol for management of low-grade appendiceal mucinous neoplasm (LAMN). Indian J Surg Oncol, 11(3): 355-359, 2020.
8. Matsui S, Murata K, Fukunaga Y, et al. Analysis of clinicopathological characteristics of appendiceal tumors in Japan: A multicenter collaborative retrospective clinical study- A Japanese nationwide survey. Dis Colon Rectum, 63(10): 1403-1410, 2020.
9. Bosman FT, Carneiro F, Hruban RH, et al. (eds.Tumours of the appendix. In WHO Classification of Tumours of the Digestive System, 4th ed. IARC Press, Lyon, pp. 119-129, 2010.
2. Wang AS, Ismael HN, Parikh J, Modesto V. Low-grade mucinous appendiceal neoplasm: A case series. Cureus, 14(10): e28755, 2022.
6. Perivoliliotis K, Christodoulidis G, Samara AA, et al. Low-grade appendiceal mucinous neoplasm (LAMN) primary diagnosed as an ovarian mucinous tumor. Case Rep Surg, 2021
14. Glasgow SC, Gaertner W, Stewart D, et al. The American society of colon and rectal surgeons, clinical practice guidelines for the management of appendiceal neoplasms. Dis Colon Rectum, 62: 1425-1438, 2019.
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References_xml – reference: 16. Solomon D, Bekhor E, Leigh N, et al. Surveillance of low-grade appendiceal mucinous neoplasms with peritoneal metastases after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: are 5 years enough? a multisite experience. Ann Surg Oncol, 27: 147-153, 2020.
– reference: 10. Borges AL, Reis-de-Carvalho C, Chorao M, Pereira H, Djokovic D. Low-grade mucinous appendiceal neoplasm mimicking an ovarian lesion: A case report and review of literature. World J Clin Cases, 9(10): 2334-2343, 2017.
– reference: 13. Yu XR, Mao J, Tang W, Meng XY, Tian Y, Du ZL. Low-grade appendiceal mucinous neoplasms confirmed to the appendix: clinical manifestations and CT findings. J Investig Med, 68: 75-81, 2020.
– reference: 14. Glasgow SC, Gaertner W, Stewart D, et al. The American society of colon and rectal surgeons, clinical practice guidelines for the management of appendiceal neoplasms. Dis Colon Rectum, 62: 1425-1438, 2019.
– reference: 8. Matsui S, Murata K, Fukunaga Y, et al. Analysis of clinicopathological characteristics of appendiceal tumors in Japan: A multicenter collaborative retrospective clinical study- A Japanese nationwide survey. Dis Colon Rectum, 63(10): 1403-1410, 2020.
– reference: 12. Yazawa R, Yazawa H, Fukuda K, Ohara M, Osuka F. Four cases of pseudomyxoma peritonei with ovarian tumors at our hospital. Fukushima J Med Sci, 2023.
– reference: 3. Ramaswamy V. Pathology of Mucinous Appendiceal Tumors and Pseudomyxoma Peritonei. Indian J Surg Oncol, 7(2): 258-267, 2016.
– reference: 1. Misdraji J, Carr NL, Pai RK. Appendiceal mucinous neoplasm. In WHO Classification of Tumors of the Digestive System, 5th ed. IARC press, Lyon, pp. 144-146, 2019.
– reference: 11. Japanese Classification of Colorectal, Appendiceal, and Anal Carcinoma. 9th edition, Kanehara shuppan, Tokyo, p. 63-64, 2018.
– reference: 7. Rossi A, Patel NM. Appendiceal neoplasm-A practical guide. J Surg Oncol, 127: 1033-1305, 2023.
– reference: 17. Inoue A, Murata K, Komori T, et al. Open versus laparoscopic surgery for primary appendiceal tumors: a large multicenter retrospective propensity score-matched cohort study in Japan. Surg Endoc, 35: 5515-5523, 2021.
– reference: 15. Gonzalez HH, Herard K, Mijares MC. A rare case of low-grade appendiceal mucinous neoplasm: a case report. Cureus, 11: e3980, 2019.
– reference: 4. Shaib W, Assi R, Shamseddine A, et al. Appendiceal mucinous neoplasms: diagnosis and management. Oncologist, 22: 1107-1116, 2017.
– reference: 9. Bosman FT, Carneiro F, Hruban RH, et al. (eds.Tumours of the appendix. In WHO Classification of Tumours of the Digestive System, 4th ed. IARC Press, Lyon, pp. 119-129, 2010.
– reference: 2. Wang AS, Ismael HN, Parikh J, Modesto V. Low-grade mucinous appendiceal neoplasm: A case series. Cureus, 14(10): e28755, 2022.
– reference: 6. Perivoliliotis K, Christodoulidis G, Samara AA, et al. Low-grade appendiceal mucinous neoplasm (LAMN) primary diagnosed as an ovarian mucinous tumor. Case Rep Surg, 2021
– reference: 5. Boshnaq M, Toeima M, Hamade A, Bagle N. Local protocol for management of low-grade appendiceal mucinous neoplasm (LAMN). Indian J Surg Oncol, 11(3): 355-359, 2020.
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Snippet We report two cases of low-grade appendiceal mucinous neoplasm (LAMN) mimicking ovarian tumors that were treated with laparoscopic surgery. Case 1: A...
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SubjectTerms laparoscopic surgery
low-grade appendiceal mucinous neoplasm (LAMN)
ovarian tumor
preoperative diagnosis
pseudomyxoma peritonei
Title Two cases of low-grade appendiceal mucinous neoplasm (LAMN) mimicking ovarian tumors successfully treated with laparoscopic surgery
URI https://www.jstage.jst.go.jp/article/fms/advpub/0/advpub_24-00051/_article/-char/en
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