Radiology Teaching Files > Case 35089541

never visited APPENDICEAL MASS
Contributed by: Sheldon Jensen, Resident, Brooke Army Medical Center, Texas, USA.
Patient: male
History: Middle aged male presents to ED with right lower quadrant pain and vomiting.

Fig. 1: thickened wall of proximal appendix connected to suspected abscess

Fig. 2: stranding, hypoattenuating wall, air-fluid level adjacent to appendix

Fig. 3: appendicolith inside suspected abscess with air-fluid level

Fig. 4: stranding, thickened appendiceal tail from suspected abscess

Fig. 5: IR consulted to put in percutaneous drain

Fig. 6: gross image of appendiceal mass

Fig. 7: gross bisected mass off appendix

Stranding and hypoattenuating mass with central air-fluid level and appendicolith connected to appendix, felt to represent abscess/ruptured appendicitis.

IR consulted to place percutaneous catheter in to drain abscess.  Catheter placed successfuly, but minimal fluid removed.

Patient taken to surgery.  Intraoperative findings of appendiceal mass.


1. Appendicitis

2. Appendiceal mass.  Path pending.


Classic carcinoid tumors of the appendix derive from subepithelial neuroendocrine cells and may represent up to 80% of all appendiceal neoplasms (2,16). Unlike with most other primary appendiceal neoplasms, its discovery at surgery or pathologic examination is most often serendipitous.  Even in the setting of acute appendicitis, a coexisting carcinoid tumor is the obstructing cause in only 25% of cases, reflecting the fact that over 70% are found in the distal third of the appendix (away from the base) and are less than 1 cm in size (2,17).

References: Primary Neoplasm of the Appendix:  Radiologic Spectrum of Disease with Pathologic Correlation, Radiographics, May-June 2003, Volume 23, Number 3
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Additional Details:

Case Number: 35089541Last Updated: 01-07-2010
Anatomy: Gastrointestinal (GI)   Pathology: Neoplasm
Modality: CT, GIAccess Level: Readable by all users
Keywords: appendix

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