Appendix cancer mimicking ovarian cancer

Area of Science:

• Oncology
• Gynecologic Oncology
• Surgical Oncology

Background:

• Appendiceal adenocarcinoma is a rare malignancy with no distinct clinical presentation.
• It can present with symptoms mimicking advanced ovarian cancer, leading to diagnostic delays.
• Elevated CA125 levels are often observed in appendiceal cancer, further complicating differential diagnosis.

Purpose of the Study:

• To highlight the challenges in diagnosing appendiceal adenocarcinoma.
• To emphasize its presentation mimicking ovarian cancer.
• To discuss treatment and survival in a small cohort.

Main Methods:

• Retrospective review of medical records and pathology for five women diagnosed with stage IV appendiceal cancer.
• Analysis of clinical presentation, surgical procedures, chemotherapy regimens, and survival data.

Main Results:

• Five women, median age 47, presented with symptoms of advanced ovarian cancer.
• All had elevated preoperative CA125 levels (median 171 micro/ml).
• Median survival was poor at 6.75 months, with palliative treatment considered appropriate.

Conclusions:

• Appendiceal adenocarcinoma should be considered in the differential diagnosis of intra-abdominal masses and ascites, especially in women.
• Accurate differentiation from ovarian cancer is critical due to differing treatment modalities.
• The role of radical tumor debulking and chemotherapy in appendiceal cancer requires further investigation.