Appendiceal adenocarcinoma

Case contributed by Hossam Mahrous
Diagnosis almost certain

Presentation

2 days of severe RIF pain. Rebound tenderness. Febrile. Raised WCC. ?appendicits ?collection

Patient Data

Age: 60 years
Gender: Female
ct

Dilated retrocecal appendix with surrounding fat stranding and free fluid. There is hypo-enhancement of the appendiceal wall at the tip, with associated further free fluid and an extramural gas locule. No appendicoliths. Appearances are in keeping with perforated appendicitis.

Case Discussion

Post-appendectomy histology diagnosis revealed adenocarcinoma of the appendix.

Primary appendiceal neoplasms are uncommon. 

In addition, there is an overlap in imaging of primary appendiceal neoplasms and acute appendicitis, as illustrated in this case. 

If only diagnosed in retrospect, careful interrogation of the remainder of the abdomen is needed for assessment of distant disease.

Case courtesy of Dr Laura Pendower.

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