Late stage diagnosis of mucinous adenocarcinoma of the appendix: a case report of an unusual tumor with a rare presentation

Roma, Katerina; Baldwin, Mark; Sedmak, Daniel D.; Silva, Matthew J.; Stellar, William; Many, Gina M.

doi:10.1186/s12876-020-01378-w

Cited by 7 publications

(9 citation statements)

References 23 publications

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“…Roma et al 13 reported a late‐stage diagnosis of appendiceal mucinous adenocarcinoma with a rare presentation, such as scrotal pain, abscess, and inguinal drainage, but our patient developed with typical symptoms, like abdominal pain, weight loss, and palpable mass, without any appendicitis alarm.…”

Section: Discussionmentioning

confidence: 57%

Retroperitoneal mass, a rare manifestation of mucinous adenocarcinoma of appendix: A case report

Salehipour

Haghpanah

Dehghani

et al. 2022

Clinical Case Reports

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The retroperitoneum (RP) might be affected by a variety of infections, inflammations, and tumors, including benign and malignant ones. Although primary malignant tumors are the most prevalent ones in this anatomic area, metastatic and invasive tumors rarely involve the retroperitoneum. Gastrointestinal stromal tumors (GISTs) are considered as the most common tumors that invade the retroperitoneum, but, to the best of our knowledge, it is the first time a surgery team has encountered the appendiceal tumor as a huge retroperitoneal mass. A 68‐year‐old man was referred to the emergency department with abdominal distension and weight loss. In his course of hospitalization, a huge right retroperitoneal mass was detected by a computed tomography (CT) scan; after that, the patient underwent laparotomy, evacuation of massive mucinous tissue located in the right retroperitoneum, and right hemicolectomy due to appendiceal tumor. The histopathological examination showed “mucinous appendiceal neoplasm.” This is the first case study showing the invasion of an appendiceal tumor through the visceral peritoneum into the retroperitoneum, so an invasion of the peritoneal tumor to the retroperitoneum should be considered when a urologist approaches retroperitoneal masses.

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Section: Discussionmentioning

confidence: 57%

Retroperitoneal mass, a rare manifestation of mucinous adenocarcinoma of appendix: A case report

Salehipour

Haghpanah

Dehghani

et al. 2022

Clinical Case Reports

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“…With an incidence rate of 37%-38% among all appendiceal cancers reported, mucinous adenocarcinoma is the most prevalent subtype of primary adenocarcinoma with a mean age of presentation at 60 years of age, no explicit sex predilection, and no known risk factors [2][3][4]. Furthermore, MAA is further classified as low and high grade, which is essential in deciding the treatment options and predicting the prognosis [2].…”

Section: Discussionmentioning

confidence: 99%

“…Appendiceal malignancies are a rare group of tumors usually found incidentally during appendectomy [1]. Adenocarcinoma is the most predominant type of primary appendix cancer, comprising 60% of all cases, and mucinous adenocarcinoma of the appendix (MAA) is the most prevalent subtype of primary adenocarcinoma with an incidence rate of 37%-38% among all appendiceal cancers [2][3][4]. In terms of clinical presentation, in over 50% of cases of appendiceal cancer, the patient is asymptomatic, and the malignancy is detected incidentally [1].…”

Section: Introductionmentioning

confidence: 99%

Rare Mucinous Adenocarcinoma of the Appendix Undergoing Multiple Recurrent Surgical Interventions

Ilyas¹,

Umar²,

Pansuriya³

et al. 2023

Cureus

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Primary appendiceal carcinomas are rare and often found incidentally when the appendix is surgically removed. Adenocarcinoma predominates the histological types of malignancies, with mucinous adenocarcinoma being the most prevalent of the various subtypes. Pseudomyxoma peritonei (PMP), a complication seen in mucinous adenocarcinoma of the appendix (MAA), is the collection of mucinous ascites in the intra-abdominal cavity and the thickening of the surrounding viscera by mucin-producing tumor cells. PMP initially presents with increased abdominal discomfort and girth and, in later stages, presents with obstructive abdomen symptoms. These symptoms are nonspecific and can be a challenge to pinpoint. Such was the case for our patient, in this case report, who initially presented with dyspepsia and later demonstrated compressive symptoms and weight loss, raising concern for malignancy. An appendiceal pathology was of concern when his right lower quadrant pain acutely worsened during an abdominal ultrasound, and imaging and biopsy confirmed MAA with PMP. The aim of this report is to shed light on the management of recurrent MAA. Our patient's recurrent MAA was managed with debulking procedures and three rounds of hyperthermic intraperitoneal chemotherapy (HIPEC) and was managed postoperatively with folinic acid, fluorouracil, and irinotecan (FOLFIRI) and bevacizumab, which in its totality helped achieve a progression-free survival of more than two years. We believe that cytoreduction and intraoperative chemotherapy prolong survival in patients with recurrent disease, as was the case with our patients. Our patient also demonstrated benefit as his disease stabilized after starting bevacizumab; however, more studies need to be performed at a larger scale to show a consistent relationship.

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“…MAA is difficult to diagnose due to the non-specific nature of early symptoms, including lower abdominal pain, weight loss, nausea, vomiting, a palpable mass, and acute appendicitis, and is frequently misdiagnosed as a gynecological condition such as right adnexal mass[ 7 ]. The bladder may also be affected, with symptoms of bladder irritation or the formation of hematuria, leading to a misdiagnosis of urinary tract infection or bladder cancer[ 8 - 10 ]. In most cases, appendiceal malignancy is detected accidentally by abdominal CT or surgery for appendicitis due to other reasons.…”

Section: Discussionmentioning

confidence: 99%

Accidental discovery of appendiceal carcinoma during gynecological surgery: A case report

Wang¹,

Dong²,

Chen³

et al. 2022

WJCC

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BACKGROUND Malignant tumors of the appendix are extremely rare, constituting about 1% of all gastrointestinal tumors. Generally, pathology identifies these tumors during or after appendectomy because they are difficult to detect at the preoperative stage. This case report aims to introduce the definitive diagnosis and treatment of mucinous adenocarcinoma of the appendix. CASE SUMMARY A 49-year-old female patient came to our hospital with right lower abdominal pain, nausea, and vomiting for three days. There was no change in the menstrual cycle. Gynecological ultrasound showed a cystic, solid mass in the right adnexa. Abdominal enhanced computed tomography showed a thick appendix. Cancer was found on exploration of the appendix during gynecological surgery. The right colon was removed. After surgery, the patient received chemotherapy and is recovering well. CONCLUSION Appendiceal carcinoma is frequently found during or after surgery, and both preoperative examination and early evaluation of clinical manifestations are extremely important.

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Late stage diagnosis of mucinous adenocarcinoma of the appendix: a case report of an unusual tumor with a rare presentation

Cited by 7 publications

References 23 publications

Retroperitoneal mass, a rare manifestation of mucinous adenocarcinoma of appendix: A case report

Retroperitoneal mass, a rare manifestation of mucinous adenocarcinoma of appendix: A case report

Rare Mucinous Adenocarcinoma of the Appendix Undergoing Multiple Recurrent Surgical Interventions

Accidental discovery of appendiceal carcinoma during gynecological surgery: A case report

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