Appendiceal Intussusception Secondary to Primary Appendiceal Cancer—A Case Report—

Abstract

A 61-year-old man showed positive fecal occult blood test results and was referred to our hospital for further evaluation and treatment of a columnar protuberant lesion extending from the cecum to the ascending colon, which was detected on colonoscopy. Contrast-enhanced abdominal computed tomography revealed a cecal lesion with a fatty structure that contained vessels, which appeared to be mesenteric vessels within the columnar protuberant lesion that was detected on colonoscopy, and we suspected appendiceal intussusception. Histopathological evaluation of the resected specimen confirmed diagnosis of an adenocarcinoma in adenoma. The patient did not show any abdominal symptoms ; therefore, we decided to perform elective laparoscopic ileocecal resection. Intraoperatively, we observed appendiceal intussusception into the cecum, consistent with the preoperative diagnosis. It was difficult to reduce the intussusception ; therefore, we performed laparoscopic ileocecal resection (D3 dissection) as planned. Histopathological examination revealed a ductal adenoma involving the entire colonic circumference except the appendiceal root with adenocarcinomatous lesions in some areas. Appendiceal intussusception is relatively uncommon and can be treated with emergency surgery ; however, elective laparoscopic surgery may be indicated in patients without appendiceal ischemia or necrosis. We report a case of appendiceal intussusception in a patient with appendiceal cancer, along with a literature review.