A CASE OF APPENDICEAL CANCER WITH FISTULA FORMATION TO THE SKIN AND ASCENDING COLON

Abstract

Primary appendiceal cancer is rare, especially that with fistula formation to the abdominal wall and invasion into the colon. A 67-year-old woman was referred to the hospital because of a right lower abdominal skin fistula. A fistulography revealed a fistula formation to a tumor of the ascending colon, and a colonoscopy suggested the extra-colonic origin of the tumor. Abdominal CT and magnetic resonance imaging scans demonstrated an ileocecal tumor invading the abdominal wall. A biopsy of the ascending tumor showed mucinous adenocarcinoma. We diagnosed the case as primary appendiceal cancer with fistula formation to the skin and ascending colon. Right colectomy with lymph node dissection and a fistulectomy were performed.
Histological evaluation confirmed mucinous appendiceal cancer with invasion to the ascending colon and fistula formation to the skin. The patient has been healthy for 20 months postoperatively.