Abstract
A 56-year-old man visited our hospital with a chief complaint of right lower quadrant pain that had persisted since the previous day. Appendicitis with abscess formation was suspected based on detailed examination, and it was decided that laparoscopic appendectomy would be performed on an emergency basis. Observation of the ileocecum under laparoscopic vision showed that the adhesion with surrounding tissue was stronger than expected for an appendicitis that had developed the previous day, and it was judged necessary to also consider abnormalities other than inflammatory changes, such as cancer invasion. The operative procedure was changed to drainage surgery, and it was decided that elective surgery would be performed following detailed examination. A diagnosis of appendiceal cancer was obtained on colonoscopy at a later date, and laparoscopic-assisted ileocecal resection and D3 lymph node dissection were performed electively. Accordingly, it was possible to perform radical surgery. It was considered quite feasible that the cancer would have disseminated if it had not been suspected at the time of initial surgery and appendectomy had been performed ; the present case is thus rich in suggestions for future approaches. The present case is described with a review and discussion of the cases of primary appendiceal cancer reported in Japan.
