Primary Adenocarcinoma Concomitant with Perforated Diverticulum of the Appendix —Report of a Case—

Abstract

An 81-year-old female patient was referred to our hospital for right lower quadrant abdominal pain. Abdominal computed tomography revealed swelling of the appendix with fat tissue thickening and fluid collection around the peri-ileocecal region. She was provisionally diagnosed as having a perforated appendicitis, and underwent an emergent laparotomy. The appendix was very swollen, and a proximal bulging region of the wall was perforated ; purulent ascites was present. The patient had an appendectomy. The resected specimen showed a diverticulum ; its proximal region was perforated. An intraluminal polypoid tumor was detected near the distal side of the appendix. On histology, the polyp was diagnosed as an adenocarcinoma in a tubular adenoma, which had infiltrated into the mucosal layer. The patient has remained in good health without clinical evidence of recurrence during 18 months of follow-up after the operation.