Torsion of Low-Grade Appendiceal Mucinous Neoplasm (LAMN): A Case Report

Cureus. 2024 Dec 15;16(12):e75749. doi: 10.7759/cureus.75749. eCollection 2024 Dec.

Abstract

A low-grade appendiceal mucinous neoplasm (LAMN) is a rare condition, occurring in 0.08-4.1% of appendectomy cases. Although this condition is frequently asymptomatic, it may occasionally result in acute complications, including torsion and rupture. We report the case of a 33-year-old male who presented with upper abdominal pain. Contrast-enhanced computed tomography (CECT) revealed a 3 cm cystic lesion in the appendix with 360° torsion at its base. Laparoscopic surgery confirmed the torsion, and the appendix was successfully resected without mucin spillage. Histopathological examination confirmed the diagnosis of LAMN. The postoperative course was uneventful, and the patient was discharged on postoperative day four. At 2.5 years follow-up, no recurrence was observed. This case highlights the rarity of LAMN torsion and the challenges in its preoperative diagnosis. The use of advanced imaging techniques, such as CECT, is crucial in identifying the torsion preoperatively, enabling timely surgical intervention. Furthermore, the successful laparoscopic resection without mucin spillage demonstrates the importance of meticulous surgical technique in preventing complications such as Pseudomyxoma peritonei (PMP), ensuring a favorable prognosis.

Keywords: acute abdomen; lamn; laparoscopic surgery; low-grade appendiceal mucinous neoplasm; torsion.

Publication types

  • Case Reports