A Case of Appendiceal Carcinoma in a Young Woman

A Blind Spot in Interval Appendectomy

Abstract

Appendiceal carcinoma is a relatively rare disease, but recently the frequency of interval appendectomy procedures for cases of appendicitis with expected advanced inflammation and abscess formation in the appendix area has been increasing. The patient reported here was a 35-year-old woman who was referred to us with suspected acute appendicitis, as her chief complaint was right lower abdominal pain. Abdominal CT revealed acute appendicitis accompanied by appendiceal abscess formation and the patient was treated with antibiotics as a bridge to interval appendectomy. Although there was a trend towards improvement, the patient’s symptoms of abdominal pain and fever worsened on the fourth day of hospitalization, and urgent laparoscopic appendectomy was performed. Histopathological examination revealed findings of a well-differentiated adenocarcinoma of the appendix invading the submucosal layer. The stump was negative. Thereafter, ileocecal resection with D2 lymphadenectomy was performed, and the patient has shown no evidence of relapse since the surgery. The decision for interval appendectomy may delay resection in cases of cancer, therefore, even in young people, it is necessary to determine the appropriate treatment policy bearing in mind the possibility of appendiceal cancer.