A Case of Goblet Cell Adenocarcinoma of Appendix Diagnosed after Interval Laparoscopic Followed by Conservative Treatment and Treated by Additional Ileocecal Resection

Abstract

A 52-year-old-man visited hospital with right lower abdominal pain. We diagnosed acute appendicitis and intraperitoneal abscess. We decided to perform interval appendectomy and started antibacterial treatment. Antibacterial treatment was successful and the patient was discharged. Laparoscopic appendectomy was performed six month later. Only thickening of appendix mucosa was found in the specimen, but postoperative pathological diagnosis revealed goblet cell adenocarcinoma（GCA）of appendix. There was a risk factor associated with invasion depth T4, we performed ileocecal resection（D3）one month after the first surgery. The postoperative pathological examination result was pT4aN0M0 pStageⅡ．Recurrence has not been observed 18 months later. This case was an appendiceal GCA which was accidentally found in a specimen after interval appendectomy and treated by additional surgery. Infrequently, there are some reports of acute appendicitis associated with appendiceal tumor. In clinical practice, it is difficult to perform interval appendectomy for all appendicitis cases after conservative treatment, but it is suggested that for complicated appendicitis, we should perform interval appendectomy in consideration of age, ADL, and social background.