J Pathol Transl Med.  2025 Mar;59(2):139-146. 10.4132/jptm.2024.12.27.

Mucocele of the rectal stump: mucinous cystic neoplasm with low-grade dysplasia simulating low-grade appendiceal mucinous neoplasm

• Aydin HB
• Faraz M
• Chismark AD
• Qiu H
• Lee H

• KMID: 2566164
• DOI: http://doi.org/10.4132/jptm.2024.12.27

Abstract

Mucoceles, commonly observed in the appendix, are mucin-filled, dilated structures arising from a range of etiologies. Cases associated with dysplastic or neoplastic epithelium can rupture and disseminate within the abdominopelvic cavity. Similar lesions in other parts of the colon are exceedingly rare, with only 16 colonic mucoceles having been reported. The first case of a colonic mucinous neoplasm with dysplasia resembling a low-grade appendiceal mucinous neoplasm involving rectal stump was described in 2016. Here, we present the second such case arising in the rectal stump, identified in a 44-year-old male with extensive surgical history. Microscopic examination revealed low-grade dysplastic epithelium lining the cyst and mucin dissecting into the stroma, without evidence of rupture or extramural mucin. The patient was followed for 16 months without recurrence or peritoneal disease. The exact etiology and outcome of these rare lesions remain unknown, requiring close follow-up.

Keyword

Mucocele; Colonic mucocele; Cystic mucinous neoplasm; Low-grade mucinous neoplasm; Rectal stump

Figure

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  Fig. 1. Abdominal computed tomography scan demonstrating a large, multiloculated cystic mass within the pelvis (coronal [A] and sagittal [B] planes respectively).

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  Fig. 2. Scanning view of the lumen lined by attenuated colorectal type mucosa (A), denuded area (B), colorectal mucosa (C), and anorectal transitional type mucosa (D).

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  Fig. 3. (A) Scanning view of the lumen lined by attenuated colorectal type mucosa. (B) High-power view showing low-grade dysplasia. (C) Acellular mucin pools dissecting stroma. (D) Mucin pools with degenerative calcifications.

Reference

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