Wiley Acta Medica Okayama 2050-0904 13 1 2025 Undetermined Ruptured Low-Grade Appendiceal Mucinous Neoplasm Following High-Energy Blunt Abdominal Trauma Requiring Emergency Laparotomy e70071 EN Ippei Matsuo Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Tetsuya Yumoto Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Akari Tsuji Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Ryo Tanabe Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Toshihisa Matsumura Department of Digestive Surgery, Japanese Red Cross Okayama Hospital Mikoto Shimabara Department of Digestive Surgery, Japanese Red Cross Okayama Hospital Masaaki Akai Department of Digestive Surgery, Japanese Red Cross Okayama Hospital Shoji Takagi Department of Digestive Surgery, Japanese Red Cross Okayama Hospital Hiromichi Naito Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Atsunori Nakao Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Blunt abdominal trauma causing intraperitoneal injury and/or bleeding can be life-threatening, requiring immediate intervention. Diagnosing these cases can be challenging, especially when pre-existing conditions are involved. Low-grade appendiceal mucinous neoplasm (LAMN) is a rare tumor of the appendix that can lead to pseudomyxoma peritonei. Herein, we present a case of ruptured LAMN following blunt abdominal trauma after a high-energy head-on collision, complicating the differentiation from other intraperitoneal injuries. A 42-year-old Japanese female was brought to our hospital following high-energy head-on collision. She presented with stable vital signs, complaining of anterior chest pain and abdominal tenderness without peritoneal irritation. Computed tomography scans indicated multiple fractures in her chest and complex fluid around the Douglas fossa extending to the ileocecal area, with a slightly dilated appendix tip. Despite stable vitals, emergency laparotomy was needed for suspected peritonitis and/or intraperitoneal hemorrhage. Emergency laparotomy revealed yellowish, jelly-like ascites and a ruptured appendiceal tumor. LAMN was suspected, and the appendix was completely resected, with cytoreductive surgery carefully performed. Histopathological examination confirmed the diagnosis of LAMN. Postoperative course was uneventful, and the patient was discharged on Day 13 and referred for further LAMN management. This case report highlights the diagnostic difficulties of LAMN rupture following blunt abdominal trauma, stressing the need to consider rare conditions like LAMN in differential diagnoses of acute abdomen posttrauma. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 2050-0904 13 1 2025 Eyelid Spindle Cell Lipoma: Case Report and Review of Three Patients in Literature e70097 EN Toshihiko Matsuo Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Kiyoshi Yamada Plastic and Reconstructive Surgery, Kousei Hospital Yasumasa Monobe Department of Pathology, General Medical Center, Kawasaki Medical School Takehiro Tanaka Department of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University A 39-year-old woman presented a saucer-shaped mass in the left upper eyelid and underwent the extirpation at local anesthesia. Pathologically, collagen fibers, capillaries, small vessels, and CD34-positive spindle cells were dispersed among mature adipose tissues, indicative of spindle cell lipoma. Long-lasting cyst-like eyelid masses would be usually dermoid cysts, and spindle cell lipoma would be listed as a rare pathological diagnosis in differential diagnoses of cyst-like lesions in the upper and lower eyelid. No potential conflict of interest relevant to this article was reported.