Primary Adenocarcinoma of the Appendix Mimicking Appendicitis: A Case Report

Dr. Sanjeev Ramkrishna Kulkarni, Dr. Mahesh Reddy S, Dr. Sangeeta Biradar, Dr. Aditya Phadke, Dr. Shruti Panicker

Abstract: Introduction. Adenocarcinoma of the vermiform appendix is a rare neoplasm of the gastrointestinal tract. Presentation mimics acute appendicitis, but right iliac fossa mass and intestinal obstruction have also been reported. These presentations reflect various stages of a locally expanding tumour causing luminal obstruction of appendix. Most of them are found accidentally on appendicectomies performed for appendicitis. Adenocarcinomas of appendix are only 0.08 % of all cancers and the treatment remains controversial. Case report We here present an unusual case of a 70 year old man who presented with right sided abdominal pain for which he underwent a CT scan. This showed a perforated appendix and he was initially treated in the outpatient setting, before having an appendicectomy, the histology of which showed adenocarcinoma of the appendix. He underwent a right hemicolectomy and adjuvant chemotherapy. He has remained well from his carcinoma point of view. Conclusion Adenocarcinomas of the appendix are a category of rare cancers of the gastrointestinal tract. Although at present they are a well studied pathologic entity, the crucial issue of their preoperative diagnosis remains unsolved.

Keywords: Adenocarcinoma, Appendix, Perforated appendix, Appendicectomy, Hemicolectomy, Chemotherapy