Adenocarcinoid of the Appendix Presenting as a Disseminated Ovarian Carcinoma: Report of a Case

Tjalma, W.; Schatteman, E.; Goovaerts, G; Verkinderen, L.; Borre, F. van den; Keersmaekers, G H

doi:10.1007/pl00010053

Cited by 21 publications

(18 citation statements)

References 13 publications

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“…It is therefore difficult to diagnose this tumor preoperatively or macroscopically. 11 Mitotic cells are not frequently observed. In most cases, mitotic cells are seen at less than 1 per 10 high-powered magnification fields.…”

Section: Discussionmentioning

confidence: 97%

Adenocarcinoid of the Appendix: Report of Two Cases

et al. 2003

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Adenocarcinoid of the appendix is a rare tumor with the histological features of both adenocarcinoma and carcinoid tumor. However, its biological behavior and malignant potential are still unclear. We treated two patients with this unusual tumor; a 60-year-old man and a 79-year-old woman. Both patients were initially diagnosed with acute appendicitis followed by an appendectomy. At surgery, the appendix was seen to be acutely inflamed without any macroscopic signs of tumor. Postoperative histological analysis revealed an adenocarcinoid tumor in the appendix, which had spread diffusely into its wall without forming a mass. Immunohistochemical staining with p53, MIB-1, bcl-2, and carcinoembryonic antigen suggested that neither of these tumors were particularly aggressive. Adenocarcinoid of the appendix is a rare tumor, which is very difficult to diagnose preoperatively and even macroscopically, making histological examination essential.

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Section: Discussionmentioning

confidence: 97%

Adenocarcinoid of the Appendix: Report of Two Cases

et al. 2003

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“…Goblet cell carcinoid of the appendix is an uncommon neoplasm that can be found as an incidental finding in asymptomatic patients, cause acute appendicitis (the most common presentation), or lead to fatal widespread metastatic disease [22]. The histogenesis of GCC is still controversial, and whether GCC is a variant of the classical carcinoid tumor or a low-grade appendiceal adenocarcinoma is the subject of debate with proponents of both arguments.…”

Section: Discussionmentioning

confidence: 99%

Cytokeratins 7 and 20 Immunoexpression Profile in Goblet Cell and Classical Carcinoids of Appendix

et al. 2007

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Goblet cell carcinoid (GCC) of the vermiform appendix is an uncommon neoplasm and its histogenesis is controversial. Whether GCC represents a morphological variant of classical appendiceal carcinoid or a mucin-producing adenocarcinoma is still conjectural. Little is known about the immunohistochemical expression of cytokeratins 7 (CK7) and 20 (CK20) in appendiceal neuroendocrine tumors. In this study, we compared the expression of CK7 and CK20 in 17 cases of appendiceal GCC and 25 cases of classical carcinoid. The tumors were also evaluated for Ki-67 proliferation index, mitotic activity, tumor necrosis, extracellular pools of mucin, obvious intestinal type adenocarcinomatous foci, angiolymphatic permeation, perineural/neural infiltration, and the depth of invasion of the appendix wall. Mesoappendiceal extension was present in 14 of 17 (82.3%) cases of GCC, whereas angiolymphatic and perineural/intraaneural involvement were found in 10 of 17 (58.8%) and 14 of 17 (82.3%) cases, respectively. The mitotic count ranged from 0 per 10 high power fields to 6 per 10 high power fields, with an average of 1.4 per 10 high power fields. Necrosis was not seen in any case and pools of extravasated mucin were present in 5 of 17 (29.4%) cases. Immunohistochemically, all 17 (100%) of GCC exhibited strong and diffuse immunopositivity for CK20, whereas expression of CK7 was present in 12 cases (70.5%), ranging from 5 to 50% of tumor cells being labeled. The Ki-67 labeling index ranged from 0 to 75% and showed no correlation to mitotic activity, angiolymphatic invasion or perineural/intraneural permeation. On the other hand, 25 cases of classical carcinoid tumors were consistently negative for CK7; however, 4 cases (16%) showed immunolabeling for CK20 in 25-50% of the tumor cells. The Ki-67 labeling index in classical carcinoids ranged from 0 to 5%. This study shows that in addition to the morphological differences, GCC (CK7/CK20-positive) and classical carcinoid (CK7/CK20-negative) differ in their expression of CK7 and CK20. In addition, GCC shows the same CK7/CK20 immunoexpression as colorectal adenocarcinoma. Goblet cell carcinoid should be regarded as a crypt cell or an amphicrine carcinoma rather than a variant of carcinoid tumor, a lesion that has benign connotations.

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“…There are three types of malignant tumors of the appendix: carcinoid tumors, adenocarcinomas, and a very small group of nonepithelial tumors. 3 Primary appendiceal cancer is diagnosed in only 0.9%-1.4% of appendectomy specimens. 4 Moreover, signet ring cell carcinoma of the appendix is extremely uncommon, accounting for just 0.43% of appendiceal malignancies.…”

Section: Introductionmentioning

confidence: 99%

Signet ring cell carcinoma of the appendix manifesting as colonic obstruction and ovarian tumors: Report of a case

et al. 2009

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Appendiceal cancer is rare and associated with a poor prognosis because it is usually found at an advanced stage. We report a case of appendiceal adenocarcinoma manifesting as a colonic obstruction with a lower abdominal mass. Laparotomy revealed bilateral ovarian tumors and a small appendiceal tumor with peritoneal metastases. We performed ileocecal resection, colectomy, and oophorectomy, following which a histological diagnosis of signet ring cell carcinoma was made. Immunohistochemical analysis revealed positive expression of cytokeratin 7 and 20, and mucin core protein 2 (MUC2), compatible with appendiceal cancer and Kruckenberg metastases. When a patient is found to have disseminated pelvic signet ring cell carcinoma of unknown origin, the appendix should be considered as a possible primary site.

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Adenocarcinoid of the Appendix Presenting as a Disseminated Ovarian Carcinoma: Report of a Case

Cited by 21 publications

References 13 publications

Adenocarcinoid of the Appendix: Report of Two Cases

Adenocarcinoid of the Appendix: Report of Two Cases

Cytokeratins 7 and 20 Immunoexpression Profile in Goblet Cell and Classical Carcinoids of Appendix

Signet ring cell carcinoma of the appendix manifesting as colonic obstruction and ovarian tumors: Report of a case

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