[Appendix Cancer with Long-Term Survival after Multimodality Therapy-A Case Report]

Area of Science:

• Oncology
• Gastroenterology
• Surgical Oncology

Background:

• Appendix cancer, a rare malignancy, often presents with a poorer prognosis than colorectal cancer due to frequent metastatic spread.
• Mucinous cystadenocarcinoma of the appendix requires specific management strategies.
• This report details a unique case of recurrent appendix cancer with extensive metastases.

Observation:

• A 65-year-old woman was diagnosed with Stage I appendix cancer (mucinous cystadenocarcinoma) in 2002.
• She developed ovarian metastases in 2006 and disseminated recurrence in 2011, treated with chemotherapy and surgery.
• Elevated serum CEA levels in 2016 preceded the identification of a liver tumor in 2017, leading to diaphragm resection.

Findings:

• The patient achieved long-term survival exceeding 17 years despite multiple recurrences and disseminated disease.
• Multimodality therapy, including systemic chemotherapy (bevacizumab plus mFOLFOX6) and aggressive surgical interventions, was crucial.
• Persistent follow-up and timely, aggressive treatment were key to managing this complex case.

Implications:

• This case demonstrates the possibility of long-term survival in advanced appendix cancer with comprehensive treatment approaches.
• It underscores the importance of vigilant monitoring for recurrence, even with normal imaging findings, by tracking tumor markers like CEA.
• Aggressive surgical resection and multimodal therapy can significantly improve outcomes for patients with recurrent and metastatic appendix mucinous cystadenocarcinoma.