آدنوکارسینوم موسینوس آپاندیس

فیضی, ایرج and ملکی, نصراله and طاووسی, زهرا (1393) آدنوکارسینوم موسینوس آپاندیس. Journal of Research in Medical Sciences ــ 20 (1). pp. 103-104. شاپا 1735-7136

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Official URL: http://jrms.mui.ac.ir/index.php/jrms/article/view/...


Mucinous Adenocarcinoma of the Appendix

English Abstract

Primary tumors of the appendix are unusual and most of them (almost 85 %) are carcinoids [1]. Adenocarcinomas of the appendix are rare entities, representing less than 0.5% of all gastrointestinal malignancies and 4% - 6% over lesions of the appendix neoplasm [2]. In one series, the age- adjusted incidence of cancer of the appendix was 0.12 cases per 1,000,000 people per year [3]. Here, we report a case of a mucous adenocarcinoma of the appendix, the workup of the diagnosis, and treatment results. A 72-year- old woman was admitted to our hospital with a right lower abdominal mass, without any other complaints. The patient did not report any alteration of bowel habits or body weight loss. On admission, vital sign were stable. On examination of abdomen, she had a painless soft lump in the right lower abdomen. All initial laboratory findings were normal. Computed tomography revealed a large cystic mass with irregular margins measuring 8.6×7.5×6.2 cm in the right lower abdominal cavity (Fig.1). Exploration was performed through a midline incision. During the operation a large gelatinous collection was found around the appendix (Fig.2). The origin of the mass was tip of the appendix, and was extended from liver to the pelvic. Liver, uterus and ovaries were intact. There was no lymphadenopathy. The patient was underwent appendectomy, resection of the mass, and peritoneal washing. The histopathological examination of the specimen surprisingly revealed a mucous adenocarcinoma of the appendix (Fig.3). A total colonoscopy and baseline tumor markers (CEA, CA-125, CA-19-9) were normal. The patient was reffered to oncology center, and six cycles of FOLFOX chemotherapy were administered. The patient was then scheduled for a second operation and underwent a right hemicolectomy, which is proposed as the treatment of choice for this type of neoplasms. There was no evidence of synchronous presence of ovarian tumor, but in order to avoid the risk of recurrence and given the age of the patient, bilateral oophorectomy was performed. No metastases were observed during the hospitalization and surveillance of 1 year. The colonoscopy and CT scan were performed year later and did not reveal any malignant tumour. In conclusion, primary adenocarcinoma of the appendix has diverse clinical manifestations. Recognition of carcinoma in the presence of an acutely inflamed appendix is difficult. Surgeons should keep in mind the possibility of primary appendicular malignancy when managing patients with suspected appendicular mass or acute appendicitis. Intraoperative diagnosis requires a high index of suspicion, careful intra-abdominal examination, frozen sections of all suspicious appendices, and permanent sections of all appendices. To improve the outcome, right hemicolectomy should be recommended.

Item Type:Article
زبان سند : انگلیسی
نویسنده اول :ایرج فیضی
نویسنده مسئول :نصراله ملکی
نویسنده :زهرا طاووسی
Additional Information:IF: 0.684 Abstracting and Indexing: Science Citation Index Expanded , SCOPUS, Chemical Abstracts, DOAJ, EBSCO Publishing's Electronic Databases, Excerpta Medica / EMBASE, Expanded Academic ASAP, Pubmed Central, Genamics JournalSeek, Global Health, Google Scholar, Health & Wellness Research Center, Health Reference Center Academic, Hinari, Index Copernicus, Journal Citation Report, MANTIS, National Science Library, OpenJGate, PrimoCentral, ProQuest, SafetyLit, Science Citation Index, Science Scimago Journal Ranking, SCOLOAR, SIIC databases, Summon by Serial Solutions, Ulrich's International Periodical Directory and Web of Science
کلیدواژه ها (انگلیسی):Adenocarcinoma of appendix; appendectomy; right hemicolectpmy
Subjects:WI Digestive System
WO Surgery
Divisions:Faculty of Medicine > Department of Surgery
ID Code:6441
Deposited By: Dr Nasrollah Maleki
Deposited On:09 Dec 1393 04:48
Last Modified:10 Nov 1397 10:16

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