Diverse presentations of low-grade appendiceal mucinous neoplasm

Low-grade appendiceal mucinous neoplasm (LAMN) is a rare tumor of uncertain prognosis. Early diagnosis improves prognosis and lessens the chances of progression to pseudomyxoma peritonei (PMP). We hereby report three cases of LAMN diagnosed over a year at our tertiary center. The first case was incidentally detected in a patient who underwent right hemicolectomy for carcinoma of the ascending colon. Both the other cases showed disease progression with PMP. On imaging, the third case was suggestive of a mucinous ovarian neoplasm, and on cytoreduction surgery, it was found to have LAMN involving the ovary. LAMN is often misdiagnosed due to nonspecific symptoms with acute appendicitis, retroperitoneal tumor, or ovarian neoplasm. Mostly, an incidental finding as seen in our series should be suspected in patients presenting with PMP. LAMN may remain asymptomatic, but once it ruptures, it leads to the dissemination of mucin with tumor epithelial cells in the peritoneum, which worsens the prognosis and is associated with high morbidity and mortality.