TWO CASES OF PRIMARY CARCINOMA OF THE VERMIFORM APPENDIX IN AN EARLY STAGE

Abstract

It is difficult to diagnose primary carcinomas of the vermiform appendix in an early stage preoperatively. The definite diagnosis of the disease is established by postoperative pathological examination in many cases. We report two cases of primary carcinoma of the vermiform appendix in an early stage. Another such 19 cases seen in the Japanese literature are also reviewed.
A 62-year-old women was admitted to the hospital because of right lower abdominal pain. Appendectomy was performed with a diagnosis of acute appendicitis. Microscopically, the tumor was well differentiated adenocarcinoma limited to the mucosa, but invaded the margin. So 18 days later, an ileocecal resection (D2) was added.
A 44-year-old owman was admitted to the hospital because of right lower abdominal pain. Operation was performed with a diagnosis of acute appendicitis. But a flat elevated tumor was recognized in the neck of the appendix during the surgery. So the appendix was removed completely with the neck tumor. Microscopically, the tumor invaded the submucosa. Forty-two days later, an ileocecal resection (D2) was performed. No residual tumor and lymph nodes metastasis were recognized in two cases.
We would emphasize the importance of importance of microscopic inspection during surgery as well as pathological examination after surgery by entertaining a possibility of malignant tumor in cases of adult acute appendicitis.