Abstract
During outpatient treatment for postsurgery of gastric cancer, a ring-enhanced tumor was detected in the cecum on abdominal CT of a 76-year-old man. Colonoscopy showed the protruding adenomatous lesion in the cecum and the center of lesion was concave. Endoscopic biopsy demonstrated tubular adenoma with severe atypia, and we diagnosed appendiceal intussusception caused by appendiceal tumor (adenoma or carcinoma). At laparotomy, the base of the appendix was partially inverted into the cecum, and ileocecal resection with lymph node dissection was performed. Histopathological examination revealed well differentiated adenocarcinoma in tubulovillous adenoma, which was limited to the mucosa. In Japan, reports (including the present case) of intussusception induced by appendiceal carcinoma and adenoma total 26 patients. Carcinoma was identified 17 cases, and 10 (58.8%) of which confined to mucosal or submucosal layer. These histopathological findings suggested the appropriateness of minimally invasive surgery. However the indications should be evaluated carefully, because some cases were advanced cases, with peritoneal dissemination or lymph node metastasis.
