PSEUDOMYXOMA EXTRAPERITONEI - A LETHAL COMPLICATION OF MUCINOUS ADENOCARCINOMA OF THE APPENDIX

We report the unusual case of a 56-yr-old man who presented with an ap pendix: abscess, This abscess failed to respond to standard treatment, and recurred despite operative intervention, A colocutaneous fistula developed, which initially discharged frank pus, then began dischargin g mucus via two cutaneous sinuses, No evidence of malignancy was detec ted from either repeat curettings or a diagnostic laparotomy, One and a half years after the initial presentation, histologic examination fi nally revealed mucinous adenocarcinoma of the appendix, We postulate t hat this malignancy in a retrocecal appendix resulted in a mucocele, w hich ruptured into the retroperitoneal space and drained via cutaneous sinuses, so-called pseudomyxoma extraperitonei, The patient declined further surgical intervention, and despite initial control by radiothe rapy, the tumor spread locally to involve the entire right lower quadr ant of the abdomen, The patient eventually died 39 months after the in itial presentation.