Year 2026 / Volume 118 / Number 1
Letter
The volcano sign and mucus outflow by colonoscopy - Low grade appendiceal mucinous neoplasm

51-52

DOI: 10.17235/reed.2024.10841/2024

Yuko Tasato, Yoshiki Chinen, Kyoko Arakaki, Mayumi Shiroma, Masaru Miyazato, Noriya Nakachi, Ryosaku Tomiyama, Akira Hokama,

Abstract
An 82-year-old woman presented with painless hematochezia. Colonoscopy revealed a submucosal tumor-like mass in the cecum. The appendiceal orifice was identified in the center of the prominence, showing the volcano sign. The yellowish mucus was discharged from the orifice like a lava flow, the so-called mucus outflow. She underwent laparoscopic appendectomy based on the diagnosis of appendiceal mucinous neoplasm. The pathological diagnosis was low grade appendiceal mucinous neoplasm, that is a clinical entity characterized by absence of infiltrative growth or destructive invasion. The differential diagnosis includes appendiceal polyps, lipomas, neuroendocrine neoplasms, and endometriosis. Our case underscores the importance of the volcano sign and the mucus outflow for the preoperative diagnosis of appendiceal mucinous neoplasm.
New comment
Comments
No comments for this article
References
1. Umetsu SE, Kakar S. Staging of appendiceal mucinous neoplasms: challenges and recent updates. Hum Pathol 2023;132:65-76. doi: 10.1016/j.humpath.2022.07.004.
2. Shaib WL, Assi R, Shamseddine A, et al. Appendiceal mucinous neoplasms: Diagnosis and management. Oncologist 2017;22:1107-16. doi: 10.1634/theoncologist.2017-0081.
3. Hamilton DL, Stormont JM. The volcano sign of appendiceal mucocele. Gastrointest Endosc 1989;35:453-6. doi: 10.1016/s0016-5107(89)72860-1.
4. Vashistha N, Deo A, Singhal D. Gastrointestinal: Mucocele appendix with atypical "volcano sign". J Gastroenterol Hepatol 2022;37:45. doi: 10.1111/jgh.15541.
5. Assarzadegan N, Montgomery E. What is new in the 2019 World Health Organization (WHO) classification of tumors of the digestive system: Review of selected updates on neuroendocrine neoplasms, appendiceal tumors, and molecular testing. Arch Pathol Lab Med 2021;145:664-77. doi: 10.5858/arpa.2019-0665-RA.
Related articles

Letter

An unusual cecal submucosal mass in an elderly gentleman

DOI: 10.17235/reed.2024.10606/2024

Letter

Casual finding in colonoscopy: Diphyllobothrium latum

DOI: 10.17235/reed.2024.10300/2024

Digestive Diseases Image

A long rectal foreign body successfully removed after colonoscopy

DOI: 10.17235/reed.2024.10251/2024

Digestive Diseases Image

Underwater polypectomy at the appendiceal orifice in a patient on anticoagulation

DOI: 10.17235/reed.2023.9842/2023

Letter

An uncommon colonic polyp

DOI: 10.17235/reed.2022.9160/2022

Digestive Diseases Image

Intestinal obstruction due to bariolith impaction

DOI: 10.17235/reed.2022.9084/2022

Letter

Anorectal malignant melanoma, a diagnostic challenge

DOI: 10.17235/reed.2022.9068/2022

Letter

Lead ingestion, medical emergency and action plan

DOI: 10.17235/reed.2022.9048/2022

Letter

Endoscopic findings of radiation ileitis

DOI: 10.17235/reed.2022.9036/2022

Letter

Endoscopic imaging of pneumatosis intestinalis

DOI: 10.17235/reed.2022.8972/2022

Editorial

Colonoscopy — When quality matters

DOI: 10.17235/reed.2022.8942/2022

Digestive Diseases Image

Colonic Kaposi’s sarcoma as the first clinical manifestation of undiagnosed HIV

DOI: 10.17235/reed.2022.8717/2022

Letter

Gastrointestinal lymphoma, a rare endoscopic lesion

DOI: 10.17235/reed.2022.8555/2021

Letter

Cecal MALT lymphoma: a challenging diagnosis

DOI: 10.17235/reed.2021.8526/2021

Letter

Surprises in cecal intubation: foreign bodies in the colon

DOI: 10.17235/reed.2021.8155/2021

Digestive Diseases Image

Phlebosclerotic colitis: an unusual cause of abdominal pain and hematochezia

DOI: 10.17235/reed.2020.7358/2020

Case Report

Primary colon mantle lymphoma: a misleading macroscopic appearance!

DOI: 10.17235/reed.2019.6405/2019

Digestive Diseases Image

Colorectal penetration by two intrauterine devices

DOI: 10.17235/reed.2019.5974/2018

Editorial

Colorectal cancer screening and survival

DOI: 10.17235/reed.2018.5870/2018

Letter

Bacterial endogenous endophthalmitis after colonoscopy

DOI: 10.17235/reed.2018.5658/2018

Review

Quality indicators in colonoscopy. The colonoscopy procedure

DOI: 10.17235/reed.2018.5408/2017

Letter to the Editor

A rare complication after colonoscopy: a splenic rupture

DOI: 10.17235/reed.2018.5362/2017

Letter to the Editor

Acute appendicitis after a colonic endoscopic submucosal resection

DOI: 10.17235/reed.2018.5307/2017

Digestive Diseases Image

Contribution of the virtual colonoscopy in a case of intestinal intussusception

DOI: 10.17235/reed.2017.5261/2017

Digestive Diseases Image

A bull horn fragment found on colonoscopy

DOI: 10.17235/reed.2017.5020/2017

Editorial

Issue pending: minimizing anxiety before colonoscopy

DOI: 10.17235/reed.2016.4756/2016

Digestive Diseases Image

Intrauterine device in the rectal cavity

Letter to the Editor

Primary chancre in the rectum: an underdiagnosed cause of rectal ulcer

DOI: 10.17235/reed.2017.4457/2016

Digestive Diseases Image

Pneumatosis cystoides intestinalis

Letter to the Editor

Splenic rupture after colorectal cancer screening

DOI: 10.17235/reed.2015.3714/2015

Citation tools
Tasato Y, Chinen Y, Arakaki K, Shiroma M, Miyazato M, Nakachi N, et all. The volcano sign and mucus outflow by colonoscopy - Low grade appendiceal mucinous neoplasm . 10841/2024


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 2 visits.
This article has been downloaded 0 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 07/10/2024

Accepted: 15/10/2024

Online First: 24/10/2024

Published: 14/01/2026

Article Online First time: 17 days

Article editing time: 464 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2026 y Creative Commons. The Spanish Journal of Gastroenterology