Management of an unexpected appendiceal neoplasm

Murphy, Elizabeth; Farquharson, S.; Moran, Brendan

doi:10.1002/bjs.5385

Cited by 98 publications

(79 citation statements)

References 82 publications

(112 reference statements)

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“…International literature report only nine cases of vesico-appendiceal fistulas derived from mucinous appendiceal adenocarcinomas until present data 1,2,3,4,8 . This type of tumor usually perforates before diagnosis and may spread to the peritoneal cavity, producing mucinous intraperitoneal ascites, resulting in the pseudomixoma peritonei 7 . The initial assessment of the incidental appendiceal tumor includes assessment of tumor size, involvement of the base of the appendix or the mesoappendix and its perforation 7 .…”

Section: Discussionmentioning

confidence: 99%

“…An emergency cryostat sectioning should be done and if an invasive non-mucinous adenocarcinoma of the appendix is shown a right hemicolectomy can double the survival achieved with routine appendicectomy 1 . In tumours larger than 2 cm or with invasion of the base or mesoappendix, a right hemicolectomy should be performed 7 .…”

Section: Discussionmentioning

confidence: 99%

“…Such patients and those who present with a perforated mucinous neoplasm, without evidence of any extra-appendiceal spread, are at risk of developing pseudomixoma peritonei and should be followed up carefully. CT of the abdomen and pelvis and tumour markers (CEA, CA 125 and CA 19.9), provide baseline measurements 7 . At the present case the leakage of peritoneal cavity led to perform the warm mitomycin solution wash.…”

Section: Discussionmentioning

confidence: 99%

“…In this cases the peritoneal cavity should be thoroughly washed out, and the patient should be referred to an appropriate specialized center for definitive treatment 7,9,12 .…”

Section: Discussionmentioning

confidence: 99%

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Vesico-appendiceal fistula in a mucinous adenocarcinoma of the appendix

Orso

Pinto

Ramos

et al. 2008

ABCD, arq. bras. cir. dig.

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BACKGOUND: A rare case of vesicoappendiceal fistula secondary to mucinous adenocarcinoma of the appendix is presented. CASE REPORT: A 62-year-old man with a one year history of recurrent urinary tract infections. After two months he developed pneumaturia and fecaluria. An abdominal and pelvic computed tomography demonstrated a trans-mural mass in the posterior wall of the bladder with a vesicoenteric fistula leading to the terminal ileum. Laparotomy revealed a tumor arising from the appendix contiguous with the bladder posterior wall. The bladder was opened and a large fistula and tumor on the posterior bladder wall near the trigone was identified. Frozen pathological analysis showed a mucinous adenocarcinoma. En-bloc right hemicolectomy and partial cystectomy, preserving bladder trigone was performed. After manipulating the tumor, grossly leakage of mucinous materials occurred into the pelvic cavity. A peritoneal washing with a mytomicin solution at 42º C was then performed, to prevent peritoneal seeding. The patient had a prolonged postoperative ileus and was discharged at the 15th day. Five months after the procedure the patient was recieving chemotherapy with 5-fluoracil and leucovorin and there was no signs of recurrent disease. CONCLUSION: The presentation with vesico-appendiceal fistula is extremely rare with only a few cases reported in the literature. Knowledge of different types of neoplasm and appropriate treatment allows the surgeon to provide patients optimal care referring to specialized centers whenever appropriate.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…In this cases the peritoneal cavity should be thoroughly washed out, and the patient should be referred to an appropriate specialized center for definitive treatment 7,9,12 .…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Vesico-appendiceal fistula in a mucinous adenocarcinoma of the appendix

Orso

Pinto

Ramos

et al. 2008

ABCD, arq. bras. cir. dig.

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“…In addition, carcinoma of the appendix, carcinoids, or mucocele appendix may be observed rarely. Appendiceal malignancies are rare clinic entities and have been reported to constitute 1% of all colorectal malignancies and 1% of all appendectomy specimens (2). Clinical presentation of appendiceal malignancies is often atypical, which makes its diagnosis controversial and challenging in some patients.…”

Section: Introductionmentioning

confidence: 99%

Appendix adenocarcinoma in an elderly patient from a nursing home

Sönmez

Bayhan

Yaylak

et al. 2016

UCD

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Appendiceal malignancies are rare clinic entities. The clinical presentation of appendiceal malignancies is often atypical. Acute abdominal pain and acute appendicitis, which requires early surgical intervention, are the most common clinical presentations of appendiceal malignancies. In this case report, an adenocarcinoma of the appendix in a 64-year-old male from a nursing home has been presented. He had right lower quadrant pain for the last 5 days. On physical examination, he had significant guarding. Intravenous contrast-enhanced abdominopelvic tomography revealed no pathological features. Laparotomy under general anesthesia was scheduled. During exploration, a perforated appendicitis was observed. Formal appendectomy was performed. The patient was lost due to pneumonia and septic shock 5 days after surgical intervention. In addition, the natural history of the disease and its basic diagnostic and therapeutic aspects are discussed. Preoperative or intraoperative diagnosis may not be available for some patients. Thus, routine histopathological examination is essential for adequate diagnosis and treatment.

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