Xanthogranulomatous appendicitis diagnosed on routine PET scan: a case report

Area of Science:

• Gastroenterology
• Pathology
• Oncology

Background:

• Xanthogranulomatous appendicitis (XGA) is an uncommon inflammatory condition of the appendix.
• XGA often presents atypically, leading to a post-operative diagnosis via surgical pathology.
• Interval appendectomies are frequently associated with XGA due to delayed diagnosis.

Observation:

• A patient with stage IV lung adenocarcinoma underwent a routine Positron Emission Tomography (PET) scan.
• The PET scan incidentally identified acute appendicitis in a minimally symptomatic patient.
• Subsequent pathological examination confirmed Xanthogranulomatous appendicitis (XGA).

Findings:

• This case presents a rare instance of XGA diagnosed pre-operatively following incidental findings on a PET scan.
• The diagnosis occurred prior to an interval appendectomy, challenging the typical diagnostic pathway for XGA.
• The findings underscore the varied presentations of XGA and its potential detection through advanced imaging.

Implications:

• Further research is needed to understand the atypical presentations of XGA.
• The role and timing of interval appendectomies in cases of acute appendicitis, particularly when XGA is suspected, require further investigation.
• Integrating advanced imaging like PET scans may aid in earlier detection of rare appendiceal pathologies.