When the Appendix Speaks: Colonoscopic Recognition of an Appendiceal Mucocele

Appendiceal mucoceles are rare, often asymptomatic lesions caused by mucin accumulation within the appendix and carry a risk of rupture leading to pseudomyxoma peritonei.We report a case of a 60-year-old man undergoing routine screening colonoscopy in whom a smooth, dome-shaped protrusion of the appendiceal orifice was incidentally identified.No biopsy was performed due to concern for underlying appendiceal pathology.Contrast-enhanced CT revealed a 2.2-cm dilated, fluid-filled appendix consistent with a mucocele.The patient underwent elective laparoscopic appendectomy, and histopathology confirmed a low-grade appendiceal mucinous neoplasm confined to the appendix with negative margins.This case highlights the importance of careful endoscopic evaluation of the appendiceal orifice and timely surgical management to prevent complications.