Abstract
A 69-year-old man was referred to our hospital because of a tumor of the appendix detected at a medical checkup. There was slight tenderness in the right lower quadrant of abdomen. Serum biochemical studies revealed no abnormal findings. The serum level of CEA slightly elevated to be 8.2 ng/ml. An abdominal contrast-enhanced CT scan showed an enlarged appendix 70×30 mm in diameter, with fluid collection in it. Colonoscopy revealed a volcano sign, which designates that the orifice of the appendix has bulged like a dome. Although a biopsy gave negative findings, mucinous cystadenoma of the appendix was suspected. We performed ileocecal resection and dissection of lymph nodes up to the root of the ileocolic artery. The resected specimen included transparent, colorless and jelly like mucus in the lumen of the appendix. Histopathological studies showed mucus producing tumor cells at the tip of the appendix and mucinous cystadenoma was diagnosed. In addition we found a tumor composed of goblet cells mainly located in the submucosal layer at the root of the appendix. As a result of immunohistochemical studies, it was diagnosed as goblet cell carcinoid.
