A Case of Appendiceal Cancer Arising from Appendicostomy 20 years after Surgery

Abstract

An 84-year-old man was admitted to our hospital for a tumor arising in the right lower abdomen. He had undergone laparotomy twice: one was a gastrectomy for gastric cancer and the other was adhesiolysis and appendicostomy for repeated intestinal obstruction at 62 years of age. The appendicostomy was closed spontaneously for twenty years. Two years before admission, he had a subcutaneous abscess under the scar of the appendicostomy and was treated with drainage. However, the situation did not improve and a tumor was forming. Physical examination showed a necrotic tumor, 4 cm in diameter, on the right lower quadrant. Abdominal computed tomography showed a mass bulging into the cecum lumen through the abdominal wall. Biopsy of the tumor revealed well-differentiated adenocarcinoma. At first he was diagnosed with cecum cancer invad-ing the abdominal wall and skin, and ileocecal resection combined with abdominal wall was performed. The macroscopic finding revealed that the tumor originated from the appendicostomy. Histopathological examination confirmed a diagnosis of appendiceal cancer derived from the appendicostomy. We report this rare case of appendiceal cancer derived from an appendicostomy, with a review of the literature.