Primary Carcinoma of the Appendix

Abstract

Primary adenocarcinoma of the appendix is rare and less than 200 cases are on record. The present material consisted of 20 cases collected from different hospitals. The cases are described in respect of sex and age-distribution, symptoms, treatment and prognosis. Of 7 patients with malignant mucocele, 6 subjected to appendectomy only, were still alive 5 years after the operation. Of 12 patients with colonic type of adenocarcinoma, 3 had been treated with appendectomy only. Of these, 2 were still alive 5 years after the operation. The remaining 9 patients had undergone right hemicolectomy. Only one of them was alive 5 years after the operation. A compilation of a further 39 cases garnered from the literature, however, showed that 60% had survived at least 5 years after right hemicolectomy, compared with 46% after appendectomy alone. Appendectomy alone is probably a sufficiently radical operation for malignant mucocele provided the tumor has not grown through the submucosa and that it is confined to the tip of the appendix. Right hemicolectomy is indicated for the colonic type of adenocarcinoma.

Appendiceal mucocele: Case reports and review of current literature

“…The spontaneous and surgery induced complications of AM include intestinal obstruction, intussusceptions [20,22] , intestinal bleeding [11,13,25] , fistula formation [15,26] , and volvulus [27,28] . The worst complication is pseudomyxoma peritonei, characterized by peritoneal dissemination caused by iatrogenic or spontaneous rupture of the mucocele [5] .…”

“…Long term followup in this case has been carried out in the outpatient clinics. Perforated mucocele with positive cytology but negative margins of resection and negative appendiceal lymph nodes should be treated with appendectomy/CRS/HIIC and EPIC [26,30] . We did not apply these treatment modali-ties as none of our patients had had positive lymph nodes or perforated mucocele.…”

Mucinous epithelial neoplasms of the appendix and pseudomyxoma peritonei

“…There is an increased incidence among men in some series 8,[49][50][51][52][53][54][55][56] but not in others. [57][58][59][60] Patients are usually in their fifth to seventh decade of life at presentation 49,[51][52][53][55][56][57][58]60 and usually present with symptoms of acute appendicitis.…”

Adenocarcinoma of the appendix — case study

“…In literature, only about 250 cases have been described [3,4]. The illnesses are most often diagnosed in patients between 40 and 80 years of age [5].…”

“…Lack of specific symptoms of the primary cancer of the appendix makes the initial preoperative diagnosis usually acute appendicitis, more rarely a gastrointestinal obstruction or ovarian tumor [2,5]. A proper diagnosis of the cancer is only achieved on the basis of a histological examination of the removed appendix.…”