Two concurrent appendiceal neoplasms in an elderly patient: A case report

Area of Science:

• Gastroenterology
• Surgical Oncology
• Geriatric Medicine

Background:

• Acute appendicitis is common but presents atypically in the elderly.
• Atypical presentations necessitate considering rarer etiologies beyond standard appendicitis.

Purpose of the Study:

• To highlight the importance of considering appendiceal cancer in elderly patients presenting with appendicitis.
• To discuss the diagnostic and management implications of appendiceal neoplasms in the geriatric population.

Main Methods:

• Case report of an elderly female with lower abdominal pain, diagnosed with appendicitis via CT scan.
• Laparoscopic appendectomy performed, with intra-operative findings prompting frozen-section analysis.
• Final pathology revealed low-grade appendiceal mucinous neoplasm and a carcinoid tumor.

Main Results:

• Appendectomy alone was sufficient treatment for both the mucinous neoplasm and carcinoid tumor.
• Colonoscopy was performed to rule out synchronous colonic lesions.
• The patient's condition was managed without immediate need for a right hemicolectomy.

Conclusions:

• Appendiceal cancer should be suspected in elderly patients with appendicitis.
• Early identification and pre-operative counseling can significantly alter surgical management strategies.
• The decision for right hemicolectomy in appendiceal cancers requires case-by-case evaluation.