Two cases of mucocele during laparoscopic surgery

s: Pseudomyxoma peritonei results from rupture of a mucocele. Mucoceles of gastrointestinal origin must be differentiated from ovarian tumors. Atypical, proliferative mucinous tumors and well-differentiated intestinal type mucinous adenocarcinoma may arise in a mature cystic teratoma. Pseudomyxoma peritonei has a poor prognosis, and difficulty in preoperative differential diagnosis of ovarian tumors and mucocele is an important factor. We experienced 2 cases of pseudomyxoma peritonei diagnosed at laparoscopic surgery after preoperative diagnosis of ovarian tumor. In case 1, the tumor was on the posterior rectum, and the distance with the uterus had been observed by MRI. At surgery, the ovaries were normal, and the rectal origin of the tumor was confirmed. In case 2, the CEA was elevated, but there was not a solid portion of ovarian carcinoma suspicious for tumor, and the tumor was diagnosed as appendiceal in origin. Both cases had presented atypical shapes for ovarian tumor on MRI. Because the differential diagnosis of mucocele is difficult, gynecologists sometimes encounter them at surgery. Early intervention before rupture is important, and MRI and laparoscopic surgery are important for diagnosis of pseudomyxoma peritonei.