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Appendiceal adenocarcinoma, often found incidentally during appendicitis surgery, requires prompt treatment. For advanced stages (Dukes
Area of Science:
- Gastroenterology
- Surgical Oncology
Background:
- Adenocarcinoma of the appendix is a rare malignancy.
- It often presents insidiously, mimicking acute appendicitis.
Observation:
- Three cases of appendiceal adenocarcinoma are presented.
- Diagnosis was confirmed histologically after appendectomy for acute appendicitis.
- Clinical presentation included acute appendicitis in all three cases.
Findings:
- One patient had a Dukes' B tumor and underwent right hemicolectomy.
- Another patient with likely Dukes' B disease did not have further surgery due to dementia.
- The third patient presented with advanced disease.
Implications:
- A review of 145 cases suggests right hemicolectomy for non-Dukes' A appendiceal adenocarcinoma in fit patients.
- Prognosis for appendiceal carcinoma is comparable to colorectal carcinoma.
- Early diagnosis and appropriate surgical management are crucial for improved outcomes.
Abstract:
Three cases of adenocarcinoma of the appendix are reported. All three patients presented with acute appendicitis and the tumors were diagnosed only on histologic examination of the excised appendix. The first patient subsequently had a right hemicolectomy and was proven to have a Dukes' B tumor. The second patient probably had a Dukes' B also, but no further surgery was performed because of advanced presenile dementia. Advanced disease was found in the third patient. Analysis of 145 cases reported over the last ten years suggests that, unless the tumor is in Dukes' A stage, right hemicolectomy should be carried out if the patient is fit for radical surgery. The overall prognosis appears to be the same as that for carcinoma of the colon.