Laparoscopic appendectomy for metastatic cervical cancer presenting as appendicitis

Area of Science:

• Oncology
• Gastroenterology
• Gynecologic Oncology

Background:

• Metastatic lesions to the appendix are uncommon, often presenting as appendicitis or incidentally.
• Reported primary sites include ovary, colon, gastric, and lung cancers.
• Appendiceal metastases are rare, with cervical cancer being an exceptionally rare primary source.

Purpose of the Study:

• To report a rare case of appendiceal metastasis from uterine cervical cancer.
• To highlight the diagnostic and management considerations for such rare occurrences.
• To emphasize the importance of considering distant metastases in appendiceal pathology.

Main Methods:

• A 68-year-old woman with a history of cervical cancer underwent laparoscopic appendectomy for suspected appendicitis.
• Pathological examination revealed adenocarcinoma consistent with metastasis.
• Immunohistochemical analysis (CK7+, CK20-, ER+, PgR+) supported the cervical origin.

Main Results:

• The patient presented with symptoms mimicking acute appendicitis.
• Histopathology and immunohistochemistry confirmed metastatic adenocarcinoma in the appendix.
• The appendiceal lesion's hormonal receptor profile matched the primary cervical tumor from 16 years prior.

Conclusions:

• Metastasis to the appendix from uterine cervical cancer is an exceedingly rare event.
• Laparoscopic appendectomy can be a viable treatment option for appendiceal metastases.
• Long-term follow-up and comprehensive staging are crucial for patients with a history of cancer presenting with appendiceal symptoms.