Fulminant progression of appendiceal mucinous adenocarcinoma during pregnancy: a case report

Background Appendiceal mucinous adenocarcinoma (AMAC) is exceptionally rare during pregnancy. Notably, fulminant progression of appendiceal mucinous adenocarcinoma during pregnancy has not been documented in the existing medical literature. Case presentation This case report presents a rare instance of fulminant progression of appendiceal mucinous adenocarcinoma during pregnancy: A 34-year-old obese pregnant woman (BMI 40 kg/m²) initially presented with suppurative appendicitis at 28 ^+ 1 weeks of pregnancy, which was resolved with a temporary clinical remission through conservative treatment with medication. However, the patient subsequently fulminant progression to Stage IV (T4NxM1) at 13 days. The multidisciplinary team(MDT)successfully achieved the dual objectives of maternal-neonatal safety and optimal anesthetic efficacy through implementation of an innovative sequential neuraxial-general anesthesia protocol, thereby establishing continuous surgical conditions for immediate post-cesarean cytoreductive surgerye.18-month follow-up revealed positive outcomes for both the mother and the infant, with no indications of tumor recurrence. Conclusions This case underscores the application of MDT collaboration, highlights the necessity for enhanced differential diagnosis of acute abdominal conditions during pregnancy, and emphasizes vigilance against underlying malignant pathologies that may masquerade as common acute abdominal emergencies.