Abstract Adult intussusception caused by an appendiceal mucocele is rare, and according to the WHO classification many such lesions are neoplastic, including low-grade appendiceal mucinous neoplasms (LAMNs). A woman in her forties presented with right lower abdominal pain. Computed tomography showed ileocecal intussusception with a 34-mm cystic mass as the lead point. As there were no imaging findings suggestive of malignancy or bowel ischemia, cautious endoscopic reduction was performed. Post-reduction imaging suggested an appendiceal mucocele. After one week of bowel rest, laparoscopic ileocecal resection was performed while avoiding direct tumor manipulation. Histopathology confirmed a LAMN with negative margins and no rupture. This case demonstrates that a staged strategy incorporating endoscopic reduction, bowel rest, and interval laparoscopic surgery can stabilize the patient, enable safe tumor removal, and minimize the extent of bowel resection in carefully selected, clinically stable patients without increasing operative risk or compromising oncologic principles in practice settings.
Saito et al. (Sun,) studied this question.