Nonmucinous adenocarcinoma of the cecum presenting as appendicitis complicated by hepatic abscess

Abstract

A 59-year-old man presenting with right upper quadrant pain was found to have hepatic abscesses on CT imaging. After draining the abscess, a repeat CT 3 weeks later indicated that the cause of the hepatic abscesses was appendicitis. Upon surgical resection of the base of the cecum and appendix, an adenocarcinoma was demonstrated along the cecal wall both invading and occluding the appendix. The patient was initially treated for complications of appendicitis, but this case indicates the importance of considering additional etiologies for complex appendicitis. This case report provides a pathology-proven case of well-differentiated, nonmucinous adenocarcinoma of the cecum presenting as a complication of appendicitis and discusses standard treatment options. This case report also reviews the pathophysiological aspects of hepatic abscess as a complication of appendicitis as well as the importance of considering malignancy in a patient presenting with complications of appendicitis.