A CASE REPORT OF MUCINOUS ADENOCARCINOMA OF THE RESIDUAL APPENDIX WITH FISTULA FORMATION FOLLOWING APPENDECTOMY

Abstract

A 53 year-old female was admitted to our clinical service because of pain at right lower quadrant of the abdomen. She had appendectomy in 1967. X-ray and colonof iberscopic examinations revealed serpigious, longitudinal folds and narrowing of the ascending colon. Computer tomogry aphy showed the wall thickness of involved ascending colon. The superior mesenteric arterial angiography showed hypervascular area at the arcade of the right colic and ileocolic artery. Subsequently inflammatory mesenteric disease such as a mesenteric panniculitis was initially considered. However the surgical operation revealed mucins scattered in the abdominal cavity and the tumor formation at the posterior aspect of the cecum being compatible with the location of the past appendicular removal. Histological examination showed mutinous adenocarcinoma occuring from the residual appendix or from the cecal mucosa very adjacent to the appendicular orifice associated with inflammatory fistula from the appendicular orifice to the mid ascending colon and to the terminal ileum.