Adenocarcinoma of the appendix presenting as bilateral ureteric obstruction

Ahmed, Kamran; Hoque, Robiol; El-Tawil, Sherif; Khan, Mohammad Shamim; George, Mark

doi:10.1186/1477-7819-6-23

Cited by 16 publications

(12 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In about 37% of reported cases patients usually present with acute appendicitis 6. Less commonly, they may present with an appendicular mass or abscess.…”

Section: Discussionmentioning

confidence: 99%

Primary appendicular adenocarcinoma presenting as haematuria

2014

View full text Add to dashboard Cite

Adenocarcinoma of the vermiform appendix is a rare malignant neoplasm of the gastrointestinal tract encountered rarely within general surgical practice. We present the case of a 49-year-old man who, while undergoing investigations for haematuria, was diagnosed with an appendicular adenocarcinoma following bladder biopsy. Consequently he underwent right hemicolectomy and partial cystectomy followed by adjuvant chemotherapy. By discussing this case we hope to raise awareness within the medical profession of this rare presentation so that it may be considered within clinicians' differential diagnoses.

show abstract

“…In about 37% of reported cases patients usually present with acute appendicitis 6. Less commonly, they may present with an appendicular mass or abscess.…”

Section: Discussionmentioning

confidence: 99%

Primary appendicular adenocarcinoma presenting as haematuria

2014

View full text Add to dashboard Cite

show abstract

“…Adenocarcinoma of the appendix is usually seen in the 6 th to 7 th decade with a male preponderance [2,4]. Appendicular adenocarcinoma usually presents as appendicitis with or without appendicular abscess, palpable abdominal mass, intestinal obstruction and pseudomyxoma peritonei [5]. Adenocarcinoma of appendix is most frequently perforating tumour of gastrointestinal tract due to anatomical peculiarity of appendix which has an extremely thin subserosal and peritoneal coat and the thinnest muscle layer of the whole gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 99%

“…Extraperitoneal spread is associated with relatively good prognosis by preventing the development of peritoneal carcinomatosis [6,7]. Unusual presentation includes haematuria due to bladder infiltration, direct invasion of ascending colon detected on colonoscopy, intussusception, hydronephrosis due to ureteric infiltration, retroperitoneal abscess, vaginal bleeding, lower gastrointestinal bleed, epididimitis in case of metastases to the spermatic cord or testicles, ovarian mass due to Krukenberg tumor and cutaneous infiltration [5,[8][9][10][11][12][13][14]. Management of appendiceal neoplasms should follow oncosurgical principles same as colorectal adenocarcinomas.…”

Section: Discussionmentioning

confidence: 99%

A Rare Cause of Painless Haematuria- Adenocarcinoma of Appendix

Sahu¹,

Agarwal²,

Agrawal³

et al. 2016

Surgery

View full text Add to dashboard Cite

Journal of Surgery IntroductionNeoplasms of the appendix are rare, accounting for less than 0.5% of all gastrointestinal malignancies and found incidentally in approximately 1% of appendectomy specimen. Carcinoids are the most common appendicular tumors, accounting for approximately 66%, with cystadenocarcinoma accounting for 20% and adenocarcinoma accounting for 10% [1]. We present a case of adenocarcinoma of appendix presenting only with a recurrent painless haematuria. Case ReportA 79 year male presented to our surgical clinic with history of recurrent attacks of painless haematuria since last 5 months. There was no history of any fever, pain abdomen or any other urinary complaints. Patient had history of similar attacks 5 months back for which he was investigated by routine haemogram and urine analysis. During that time his total leukocyte count was around 9000 cu/mm with urine analysis showed 15-20 red blood cells without any pus cells. He was taken up for cystoscopy which revealed a congested area in the bladder mucosa suggestive of cystitis. Then oral and intravenous contrast enhanced CT scan abdomen was planned which was reported to be acute appendicitis complicated by cystitis. Conservative management in the form Oshner Sherren's regiment with a plan of subsequent interval appendectomy was planned. Patient then had an uneventful recovery then with that conservative management. General physical examination at this time of presentation was unremarkable. Examination of abdomen showed mild tenderness in the suprapubic and right iliac fossa region without any palpable mass. Complete haemogram showed haemoglobin 13.23 g/dl, total leukocyte count-7000 cu/mm with differential leukocyte count showing neutrophil-72%, lymphocyte-18%, monocyte-10%. Routine urine test showed 5-7 red blood cells/high power fields. Liver function test and renal function test was within normal limits. Oral and intravenous contrast enhanced CT scan of abdomen was planned which showed a heterogeneously enhancing oblong mass lesion measuring approximately 6 × 2.5 cm replacing the appendix with the tip of the lesion having an ill-defined interface with the dome of the urinary bladder suggestive of infiltration. No evidence of intrinsic mass lesion was seen within the urinary bladder. No abdominal lymphadenopathy or free intraperitoneal free fluid was detected. Interface between the mass lesion with bowel loops, right iliac vessels and right ureter was well maintained (Figure 1). Patient was planned cystoscopy followed by exploratory laparotomy. On cystoscopy an external bulge in the anterior urinary bladder wall with an area of mucosal erosion showing mild bleeding was seen. No intrinsic mass lesion was detected in the urinary bladder (Figure 2). Exploratory laparotomy was done. Appendicular growth was seen invading the dome of the urinary bladder ( Figures 3 and 4). Right hemicolectomy with en bloc resection of invasion in urinary bladder was done. Primary Ileo transverse anastomosis with repair of the urinary bladder wall was done under...

show abstract

“…Appendicovesical fistulas caused by the tumor often lack specific symptoms. By occasionally appearing as a right renal mass or chronic renal failure, they cause misdiagnosis pre-operatively [2]. In some cases, it presents urinary tract infections, dysuria, pyuria, frequencies, micturition pains, and gross hematurias, which is not encountered in most surgeons' careers [3].…”

Section: Introductionmentioning

confidence: 99%

Combination of CT imaging and endoscopy in diagnosis of appendicovesical fistula caused by appendiceal adenocarcinoma

Wang

et al. 2014

Journal of X-Ray Science and Technology: Clinical Applications

View full text Add to dashboard Cite

The appendiceal diseases, particularly appendicitis, are the most common disorders in the digestive system localized at the right lower quadrant area. However, appendiceal carcinoma with vesico-appendiceal fistula is a rare clinical phenomenon. Lacking specific symptoms, appendiceal carcinomas with fistula formations are often misdiagnosed as acute appendicitis cases. The purpose of this study is to increase awareness of appendiceal neoplasms and appendicovesical fistulas. We reported our experiences in three complex cases related to digestive and urological systems, and reviewed the literature on diagnosis with various X-ray imaging techniques for this lesion. In this report, the first case failed to be diagnosed. The other two patients with appendicovesical fistulas secondary to appendiceal adenocarcinomas were successfully detected with computed tomography (CT) and cystoscopy. The patients recovered after right hemicolectomies and en bloc partial cystectomies and survived without tumor metastasis up to 7-year follow-up. In conclusion, a combined use of CT imaging and endoscopy techniques provides an accurate diagnostic alternative for appendicovesical fistula secondary to appendiceal adenocarcinoma.

show abstract

Adenocarcinoma of the appendix presenting as bilateral ureteric obstruction

Cited by 16 publications

References 7 publications

Primary appendicular adenocarcinoma presenting as haematuria

Primary appendicular adenocarcinoma presenting as haematuria

A Rare Cause of Painless Haematuria- Adenocarcinoma of Appendix

Combination of CT imaging and endoscopy in diagnosis of appendicovesical fistula caused by appendiceal adenocarcinoma

Contact Info

Product

Resources

About