Incidental pseudomyxoma peritonei of the appendix diagnosed by computed tomography with sagittal reconstruction in a woman suffering from postmenopausal metrorrhagia.

A 64-year old female patient, with no underlying diseases, was examined by a gynaecologist physician, presenting a postmenopausal metrorrhagia for one month. The oral tolerance and bowel habit remained normal in a basis daily. Neither previous traumas nor surgical or invasive studies were recorded by patient. Physical examination revealed well condition, no fever, and hemodynamic stability. His neurological, cardiological, and pulmonary examinations were normal. No lymph nodes were found. Only a suspicion of a right anexial mass was detected in abdominal evaluation. Then, an ultrasonography were ordered by Gynaecologist, showing a septated ascites mainly in pelvic cavity, in conjunction with an irregular cystic mass measuring 35 x 33 mm, and leading to suspicion of right ovary. Electrocardiogram, hemogram, white blood cell count, blood coagulation studies, blood glucose levels, ionogram, and routine kidney and liver function blood tests resulted normal. Changes in serum tumour marker level of CEA and CA 125 were not detected. The chest X-ray was normal. Ambulatory diagnostic hysteroscopy was performed, and endometrial biopsies resulted in atrophic changes. Ambulatory computed tomography (CT) of the abdomen and pelvis demonstrated the presence of non-septated ascites, associated with a cystic mass (Fig. 1), which measuring 62 x 36 mm in diameter in right pelvic compartment (Fig. 2). Appendiceal aetiology was suggested based on its location and position, its ovoid morphology, and the presence of a calcified and enhancing wall. The CT with sagittal reconstruction demonstrated that cystic mass arose from the cecum of the large colon (Fig. 3: arrow indicates the appendiceal base). All these findings together resulted to be characteristic to consider appen-