Objective: Mucinous neoplasms of vermiform appendix are rare tumors that often result in mucocoele formation. The definite diagnosis is provided on histopathology examination and further management relies on appropriate classification. In this study, we explore the histopathological spectrum of appendicular mucinous neoplasms through a series of cases encountered in practice.

Patients and Methods: This is a retrospective observational study of all emergency/ interval appendectomies from Jan 2022 to Jan 2023. Cases with extracellular mucinous lesions were included and their clinical, radiological, gross, and microscopic findings were analyzed.

Results: There were 4 cases (11.4%) out of total 35 appendectomies. These included two cases of benign retention cysts, one case of Low grade appendicular mucinous neoplasm and one case of mucinous adenocarcinoma.

Conclusions: Appendicular mucinous neoplasms can evade detection by virtue of being rare tumors with bland cytomorphology. In all cases of appendicular mucocoele, an effort must be made to confirm or rule out mucinous neoplasms/ carcinoma. Radiological findings in conjunction with characteristic histological features like subepithelial fibrosis, dissecting mucin pools or tongues of dysplastic epithelium etc. assist in diagnosis. Classification of mucinous tumors of appendix is crucial in the management and must be applied carefully.