[Difficult diagnosis: acute appendicitis and appendiceal/cecal carcinoma]

Area of Science:

• Gastroenterology and Surgical Oncology
• Pathology of the Digestive System

Background:

• Primary appendiceal and cecal carcinomas are exceptionally rare malignancies.
• Diagnosis is frequently established postoperatively via histopathological examination, with preoperative diagnosis being uncommon.

Observation:

• This study details five patients diagnosed with adenocarcinoma of the appendix or cecum base.
• All patients underwent surgical intervention between July 1998 and October 1999.

Findings:

• Ileocecal resection is the recommended surgical approach for appendiceal adenocarcinoma.
• A hemicolectomy is generally not required unless lymph nodes are positive.
• Reoperation with right hemicolectomy is necessary if carcinoma is diagnosed post-appendectomy.

Implications:

• Early and accurate diagnosis of appendiceal and cecal cancers is crucial.
• Appropriate surgical management, including ileocecal resection, can prevent the need for extensive reoperation.
• Histopathological confirmation post-appendectomy necessitates prompt re-evaluation and surgical intervention.