Perforated Appendiceal Mucinous Cystadenoma Mimicking Ruptured Appendicitis With Abscess Formation: CT Imaging Features

We describe the imaging features of a perforated appendiceal mucinous cystadenoma in a 72-year-old woman presenting with right lower quadrant abdominal pain, mimicking ruptured appendicitis with abscess formation. Computed tomography revealed a rim-enhanced cystic lesion at the proximal appendiceal orifice, connecting with the swollen and dilated distal part of the appendix. Disruption of the appendiceal walls and peri-appendiceal fatty infiltrations were also noted. Under the impression of ruptured appendicitis with abscess formation, the patient underwent exploratory laparotomy and appendectomy. The pathologic diagnosis was perforated appendiceal mucinous cystadenoma associated with superinfection, complicated by secondary appendicitis. The patient was uneventfully discharged on the 7th hospital day. Although primary neoplasms of the appendix are uncommon, they should be considered as a predisposing factor in elderly patients manifesting with appendicitis.