[Two Cases of Appendiceal Goblet Cell Adenocarcinoma]

Goblet cell adenocarcinoma(GCA)of the appendix is a rare neoplasm with histological features of both neuroendocrine tumors and adenocarcinomas. Compared to classical carcinoid tumors, GCA reveal a higher frequency of lymph node metastasis and generally have a poorer prognosis. Here, we report 2 cases of appendiceal GCA. The first case involved a 70-year- old woman who underwent elective appendectomy following management for acute perforated appendicitis. Pathology revealed a GCA with subserosal invasion(pT3), prompting additional laparoscopic ileocecal resection with D3 lymphadenectomy. The postoperative course was uneventful, and no residual tumor or nodal metastasis was observed(pStage Ⅱa). No recurrence was noted at 1-year follow-up. The second case involved a 46-year-old man with terminal ileal stenosis identified on computed tomography during an evaluation for nausea and vomiting. Colonoscopy revealed a narrowed and inflamed ileal segment;however, biopsy was non-diagnostic. Surgery was indicated after failure of conservative management. Intraoperatively, peritoneal nodules suggestive of dissemination and a tumor mass in the ileocecal region were observed. Laparoscopic ileocecal resection was conducted to preserve adjacent structures. Pathology confirmed GCA (pT4bN2aM1c1, pStage Ⅳc). The patient is currently undergoing systemic chemotherapy with CAPOX and bevacizumab. Although treatment often follows colorectal cancer protocols, no standardized regimen has been established, and further case accumulation is needed.