Abstract
A 97-year-old man was hospitalized with abdominal pain and fever. We immediately diagnosed acute appendicitis via abdominal computed tomography and initiated conservative therapy for his mild symptoms. An initial hematologic evaluation revealed a white blood cell count of 5,000/μl and C-reactive protein level of 0.38 mg/dl. However, his abdominal pain worsened and his white blood cell count increased remarkably to 20,700/μl on the following day, indicating the need for immediate appendectomy. Goblet cell carcinoid of the appendix was diagnosed postoperatively via pathological examination. Although the tumor depth was ss (T3), complete resection was achieved, and lymphatic and/or vascular invasion was not seen. Additionally, no lymph node swelling was detected clinically. Given the advanced age of the patient, we did not perform additional surgery or adjuvant chemotherapy. No recurrence has been observed after 1 year and 3 months. Goblet cell carcinoid of the appendix is rare, and mostly diagnosed following appendectomy. Additional intestinal resection is often considered because of the biologically malignant nature of this tumor. However, the decision regarding further surgery is difficult in cases involving very elderly patients. We therefore present our case together with a review of the literature, with particular focus on elderly patients.
