Primary adenocarcinoma of the vermiform appendix: Report of a series of ten cases, and review of the literature

Abstract

Ten cases of primary adenocarcinoma of the vermiform appendix are presented. The condition is rare and usually presents after middle age as acute appendicitis. It is seldom recognized during appendicectomy. The tumours resemble colonic adenocarcinomas but, because of peculiarities in the anatomy of the appendix, there is a tendency to early local spread. Right hemicolectomy performed as soon as the true nature of the lesion is recognized is the treatment of choice and has been shown to improve survival. Even after hemicolectomy the prognosis must be guarded, as local spread of disease may not be controlled in many cases.

Appendix Carcinoma Invading the Urinary Bladder

“…The reason for this is its anatomical position which is a side tract to the direct intestinal passage. Thus, the usual symptoms of intestinal tumors such as mechanical ileus and/or melena occur only in advanced stages [20], In a series of middleaged to elderly patients, abdominal pain and a palpable mass in the right lower quadrant were the leading symp toms [21]. Hematuria, [5,7,10,12], as in our patient, and recurrent urinary tract infection emanating from an enterovesical fistula [13] point out involvement of the blad der.…”

Mucinous epithelial neoplasms of the appendix and pseudomyxoma peritonei

“…Other less common modes of presentation include a palpable mass, obstruction, gastrointestinal bleeding, or symptoms related to metastases. 7,8,[51][52][53][54][56][57][58][59][61][62][63] Pathology Appendiceal adenocarcinomas are classified as adenocarcinoma not otherwise specified, mucinous adenocarcinoma, signet ring cell adenocarcinoma, and undifferentiated carcinoma. 14 Mucinous adenocarcinoma accounts for B40% of all appendiceal adenocarcinomas although it is unclear what proportion of these might be classified as LAMN according to current WHO terminology.…”

“…57,58,62 Several studies have shown that histologic grade 8,49,61 and Duke's stage correlate with prognosis. 8,57,58,61,62,68,69 Patients with peritoneal carcinomatosis have a poor prognosis. 10,52,60,62 Treatment Invasive adenocarcinoma of the appendix warrants treatment by right hemicolectomy, with lymph node dissection, in order to stage the tumor and ensure complete resection.…”

The Continuing Challenge of Acute Appendicitis

“…Despite some earlier theories [134], there is no relationship between appendicectomy and malignancy in general [135], or colorec tal carcinoma in particular [136], Occasional patients are found to have tumours of the appendix itself on histological examination; carcinoid tumours can usually be treated conservatively, but adenocarcinomas require re-operation and a right hemicolectomy [112,137],…”