The cecal mucus sign underlying appendiceal sessile serrated polyp/adenoma without dysplasia

Abstract

Neoplastic lesions of the appendix are on the rise, with mucinous appendix neoplasia the most critical in terms of preoperative diagnosis and up-front surgical treatment. A mucus-filled appendix opening, designated “the cecal mucus sign”, warrants detailed assessment for neoplastic tissue [1, 2]. With the exception of device-assisted full thickness resection, endoscopic resection techniques are highly demanding and, unless deeper appendiceal expansion and/or full-blown mucinous neoplasia can be firmly excluded, may impact patient outcomes deleteriously, particularly in relation to potential peritoneal spread [3] (Fig. 1).