[Unusual retrovesical cystic lesion: appendiceal mucocele].

Objective: Retrovesical cystic lesions are uncommon, although its incidence is growing due to the use of current diagnostic techniques. Its clinical features are unspecific and can mimic other conditions of the lower urinary tract making the differential diagnosis of this disease entity is difficult. A case of appendiceal mucocele, an unusual retrovesical lesion, is presented.

Methods/results: A 9 x 14 cm right retrovesical cystic lesion suggestive of a seminal vesicle cyst was detected in a 57-year-old patient with polyalkyuria. The patient was symptomatic, therefore surgical exploration was performed and the lesion was resected. The histological analysis of the surgical specimen demonstrated an appendiceal mucocele with no signs of atypia. The literature is reviewed, with special reference to the diagnostic and therapeutic aspects of this lesion.

Conclusions: We underscore the need to utilize the diagnostic armamentarium (transrectal US, CT, MRI, deferens vesiculography, urethrocystoscopy, colonoscopy, opaque enema, IVP, etc.) to identify retrovesical cystic lesions. Preoperative diagnosis is necessary in appendiceal mucocele to avoid rupture during the surgical procedure and prevent peritoneal pseudomyxoma. Occasionally, however, the definitive diagnosis of these retrovesical lesions can be made only by punction biopsy or surgical exploration.