We report the case of a 53-year-old man, with no history of interest, who consulted for abdominal colic pain in the lower hemiabdomen of 24 hours of evolution accompanied by fever of 39 °C, without other symptoms.
The patient presents pain to inferior hemiabdomen placement, more intense in the right iliac fossa, with defense and positive Blumberg sign.
Laboratory tests showed no leukocytosis or neutrophilia (white blood cells 8.8 x 109/L, neutrophils 70%) and abdominal X-ray showed dilatation of intestinal loops only.
An abdominal CT was requested showing a cecal appendix in pelvic arrangement, slightly thickened, with minimal inflammatory changes in the adjacent fat and a small liquid collection of 12 x 9 mm in the pelvic lymph node or free retroperitoneal pneumoperitoneum.
With the diagnosis of acute presumptive tonsillitis, a laparotomic cystectomy was performed, finding a vesicular appendix perforated with free intra-abdominal fluid.
The postoperative course was uneventful.
The pathological anatomy of the surgical specimen identifies a mucinous neoplasm of the articular origin with low degree of malignancy mucin extravasation and absence of extra-acidicular epithelium, with free margins and acute changes typical of resection.
