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Clinicopathologic correlation and survival were evaluated in 11 patients with adenocarcinomas of the appendix. This extremely rare tumor was seen most often in patients in the fifth decade of life. Acute appendicitis was the most common mode of presentation (8/11). A few patients (3/11) showed signs of distant metastases from an occult primary tumor in the appendix.
An analysis of 101 tumors of the appendix is presented. During the period under study (from 1949 to 1972), 8,699 appendectomies had been performed. Only 17 of the 101 tumors were malignant. In this group, there were two primary carcinomas, 12 metastatic carcinomas, and three lymphomas. Most of the tumors (84) were benign, including 43 carcinoids, 32 mucoceles, five neuromas, two leiomyomas, and two villous adenomas, Some of the clinical and pathologic features of carcinoids, adenocarcinoma, and mucoceles are discussed. The most significant observation in this study is the statistically significant evidence that, even without associated acute appendicitis, mucoceles 2 cm or more in diameter probably do cause clinical symptoms, which may be alleivated by appendectomy.
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This report is a retrospective evaluation of 12 case histories. All patients had been subjected to laparotomy on suspicion of acute appendicitis. The operative situations seemed to corroborate clinical expectations: an inflamed ileocecal process was assumed to be a result of performation of a gangrenous appendicitis. In three patients a primary adenocarcinoma arising from the appendiceal base was the incidental histologic finding postoperatively. In three other patients this inflammatory-looking process was related to a cecal carcinoma. In six patients a carcinoma existed unrecognized as the basic disease, these patients being subjected to intra-abdominal drainage only or in connection with appendectomy. In five instances a fecal fistula was the main persisting symptom of postoperative morbidity, in one patient even as long as two years after laparotomy. The problem in diagnostic verification of the initially unidentified carcinoma is illustrated. Attention is directed towards avoiding a false feeling of security in the presence of inflammatory manifestations in the right lower abdominal quadrant, which may misleadingly suggest a ruptured appendix.
Primary adenocarcinoma of the appendix is the rarest form of malignant tumor of the appendiceal stump is described. As with other malignancies, surgical treatment is described. As with other malignancies, surgical treatment is most effective during the early stages of disease. In our series most of the patients who had metastatic disease had fairly rapid downhill courses. The choice of right hemicolectomy with node dissection in all cases is suported.
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This report presents a case of a 23-year-old white woman who presented with symptoms of acute appendicitis, confirmed at laparotomy. The appendectomy specimen revealed an isolated, noninvasive villous adenoma of the appendix. Appendectomy was judged to be sufficient treatment in this case since the base of the organ was not involved, and there was no submucosal spread of the villous adenoma. Literature on the subject is reviewed, and modalities of surgical treatment of "invasive" villous adenoma of the appendix are discussed.
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We report a case of colonic type adenocarcinoma of the appendix with perforating peritonitis in a 92-year-old man. The preoperative diagnosis was localized peritonitis due to acute appendicitis and emergency laparotomy was performed. A gray, hard tumor was palpated at the base of the appendix. Appendiceal cancer was suspected, and right hemicolectomy was performed. The histopathological diagnosis was moderately differentiated adenocarcinoma of the appendix. The tumor obstructed the orifice of the appendix, and this may have caused the perforation of the appendix. The patient had an uneventful postoperative course and there have been no signs of recurrence in the 2 years since the operation.
A case of superficial spreading adenocarcinoma involving terminal ileum, appendix and cecum is presented. The tumor might primarily arise from the proximal part of the appendix with extension to the cecum and terminal ileum, although multicentric origin of the tumor cannot be excluded. The mechanism underlying superficial infiltration of the tumor is through close contact and intramucosal lymphatic spread.