A Case of Xanthogranulomatous Appendicitis Treated with Laparoscopic Ileocecal Resection

Abstract

A 64-year-old man presented with a one-week history of right lower quadrant abdominal pain. A mass with tenderness was felt at the right lower quadrant of abdomen. His white blood cell count was within normal range, 6,600/μL, and the C-reactive protein level was as slightly high as 1.86 mg/dL. The CEA and CA19-9 levels were within normal range, 2.8 ng/ml and 4.2 U/ml, respectively. A contrast-enhanced computed tomography showed a 20-mm enhanced mass near the bottom of the appendix and abscess formation around the appendix. He was admitted for further examination. A colonoscopy showed a red bulge located at the orifice of the appendix. Yellowish-white mucus flowed from the orifice. A biopsy of the bulge revealed Group1. But the possibility of a malignant tumor of the appendix could not be ruled out, and laparoscopic ileocecal resection, with D3 lymph node dissection, was performed. The resected specimen showed a hard mass palpable at the bottom of the appendix and abscess formation in the mesoappendix. The cut surface of the mass was yellowish-white in color. The histopathological diagnosis was xanthogranulomatous appendicitis, with no evidence of neoplastic lesion.