Abstract
The patient was a woman in her sixties who had had recurrent bouts of right lower quadrant pain every about 6 months since the summer of 2007 and had been treated with conservative therapy with a diagnosis of appendicitis at another hospital. In July 2009, she developed right lower quadrant pain and visited the previous hospital. On hematological examinations, inflammatory findings were of minor degree as the WBC count was 7700/μl and CRP was 1.5 mg/dl, but an abdominal CT scan showed an enlarged appendix. The patient was thus referred to our hospital, when her clinical symptoms had subsided. Considering that she had had recurrent bouts of right lower quadrant pain for these years, we electively performed appendectomy with a diagnosis of appendicitis. The appendix was swollen and showed dark red in color, but grossly no elevated lesion was seen on the surface of mucosa. Histopathologically signet ring cell carcinoma of the appendix was diagnosed, and the surgical margin was reported to be positive. Accordingly ileocecal excision (D2) under laparotomy was performed 22 days after the initial operation. The histopathological diagnosis was signet ring cell carcinoma, mp, n0, and stage I. The patient has been followed in the clinic.
This case of signet ring cell carcinoma of the appendix is presented here, together with a review of the literature.
