Metastasis of Breast Cancer to the Appendix Causing Acute Appendicitis

Abstract

We herein present the case of a-58-year-old female with a metastasis of breast cancer to the appendix, which caused acute appendicitis. She had undergone a bilateral partial mastectomy with sentinel lymph node biopsy ten years earlier at another hospital. She had subsequently received radiation therapy, chemotherapy and endocrine therapy. There had been no sign of recurrence for five years after the surgical procedure. She was admitted to our hospital because of abdominal pain lately. Abdominal computed tomography showed a dilated and thickened wall of the appendix. She was diagnosed with acute appendicitis and underwent appendectomy. A histopathological examination revealed metastatic breast cancer of the appendix, and the patient received endocrine therapy using an aromatase inhibitor. Metastatic involvement of the appendix should be suspected in any patient with a previous history of breast cancer presenting with acute appendicitis, even if many years have passed after initial therapy.

Metastases of breast cancer causing acute appendicitis: A case report

“…More studies are needed to explore targeted treatment to achieve better outcomes in this patient population. Although metastases to the appendix causing acute appendicitis are rare in clinical practice, this should be considered as part of the differential diagnosis when a cancer patient presents with suggestive symptoms [2]. Special attention should be given to differentiate primary and metastatic ovarian tumors in breast cancer patients, often requiring immunohistochemical studies for this precise diagnosis.…”

“…It is well known that metastases induced by breast cancer are most commonly in the lungs, bones and liver. However, metastases of the appendix are extremely rare and acute appendicitis induced by a metastatic tumor is also uncommon [2]. Ovarian metastases is more common than the metastases of the appendix.…”

“…In a review it was reported that incidental appendiceal tumor detected after appendectomy accounts for only 0.9 % of cases (74/7990), and among them, metastatic tumor was only found in 11 cases [5], showing how extremely rare appendicular metastases cases are. The primary origins of metastatic appendix tumors are the breast, lung, stomach and colon [2]. The interval between the diagnosis of a primary cancer and the onset of appendicitis has varied from zero to six years [2,6].…”

“…The primary origins of metastatic appendix tumors are the breast, lung, stomach and colon [2]. The interval between the diagnosis of a primary cancer and the onset of appendicitis has varied from zero to six years [2,6]. There are few data in the literature reporting the appearance of appendiceal metastases as the initial manifestation of primary neoplasia.…”

Acute Appendicitis Secondary to Metastatic Malignancy - A Review of 78 Cases in Literature

“…Seventeen cases [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] of metastatic breast cancer causing appendicitis were identified. The age of the patients ranged from 35 up to 90 years old, with an average age of 54 years old.…”