1997 Volume 58 Issue 3 Pages 617-621
We experienced two cases of primary cancer of the appendix which is a rare entity. Case 1 and 2 involved a 69-year-old woman and a 51-year-old man, respectively. Both patients were seen at the hospital because of a right lower abdominal tumor and their serum CEA levels were high. They had the following common findings: 1) On barium enema study, no appendix was visualized and an oppression finding in the ileocecal region was seen; 2) on colonoscopic fiber, no openning of the appendix was confirmed, extratubal oppression was seen in the ileocecal region, and ulcer formation existed in the ileum; and 3) abdominal CT and ultrasonography revealed a cystic tumor. In Case 1, tumor cells were able to be taken and the preoperative definite diagnosis (mucinous carcinoma) was made. In both Case 1 and 2, the tumors arising in the appendix invaded the terminal ileum and right hemicolectomy with lymph node dissection was carried out. These tumors were cystic macroscopically, and are mucinous carcinoma without lymph node metastasis in Case 1 and moderately or well differentiated adenocarcinoma with positive lymph nodes in Case 2, histopathologically.
In conclusion, it is important to entertain the cancer of the appendix as a probable causative disease forming a right lower abdominal tumor, and a through exploration enables us to make the preoperative diganosis.
