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New Emirates Medical Journal

Editor-in-Chief

ISSN (Print): -
ISSN (Online): 0250-6882

Case Report

Adenocarcinoma of the Appendix in Elderly: Diagnostic Dilemma

Author(s): Heba Nofal, Hayder Al-Masari*, Marwan Mohammed Rashed, Reham Ainawi, Desh Idnani and Rawan Majdalawi

Volume 2 , Issue 1 , 2021

Published on: 08 September, 2020

Page: [60 - 63] Pages: 4

DOI: 10.2174/0250688201999200908145403

open access plus

Abstract

Acute appendicitis in elderly continue to be a diagnostic dilemma as it raises both the suspicion of malignancy and increased risk of morbidity and mortality. Cancers of the appendix are rare and most of them are found accidentally on appendectomies performed for acute appendicitis. When reviewed, the majority of the tumors were carcinoid, adenoma, and lymphoma. Adenocarcinomas of appendix are only 0.08% of all cancers and the treatment remains controversial. This paper presents a case of 75-year-old female presented to the emergency (ER) with signs and symptoms mimicking acute appendicitis. Laparoscopic appendectomy was planned after a CT scan was done as it was suggesting acute appendicitis. The specimen then was sent for pathology lab and a diagnosis of adenocarcinoma of the appendix was made.

Keywords: Acute Appendicitis, Appendicitis in elderly, Tumor of the appendix, Adenocarcinoma of the appendix, CT scan edenoma.

[1]
Hardin DM Jr. Acute appendicitis: Review and update. Am Fam Physician 1999; 60(7): 2027-34.
[PMID: 10569505]
[2]
Murphy EM, Farquharson SM, Moran BJ. Management of an unexpected appendiceal neoplasm. Br J Surg 2006; 93(7): 783-92.
[http://dx.doi.org/10.1002/bjs.5385] [PMID: 16775823]
[3]
Kelly KJ. Management of appendix cancer. Clin Colon Rectal Surg 2015; 28(4): 247-55.
[http://dx.doi.org/10.1055/s-0035-1564433] [PMID: 26648795]
[4]
Carr NJ, Sobin LH. Adenocarcinoma of the appendix.WHO classification of tumours of the digestive system. Lyon: IARC 2010; pp. 122-5.
[5]
O’Donnell ME, Badger SA, Beattie GC, Carson J, Garstin WI. Malignant neoplasms of the appendix. Int J Colorectal Dis 2007; 22(10): 1239-48.
[http://dx.doi.org/10.1007/s00384-007-0304-0] [PMID: 17447078]
[6]
Aljarabah MM, Borley NR, Wheeler JM. Appendiceal adenocarcinoma presenting as left-sided large bowel obstruction, a case report and literature review. Int Semin Surg Oncol 2007; 4: 20.
[http://dx.doi.org/10.1186/1477-7800-4-20] [PMID: 17662117]
[7]
Lunca S, Bouras G, Romedea NS. Acute appendicitis in the elderly patient: Diagnostic problems, prognostic factors and outcomes. Rom J Gastroenterol 2004; 13(4): 299-303.
[PMID: 15624027]
[8]
Telfer S, Fenyö G, Holt PR, de Dombal FT. Acute abdominal pain in patients over 50 years of age. Scand J Gastroenterol Suppl 1988; 144(Suppl.): 47-50.
[PMID: 3165555]
[9]
de Dombal FT. Acute abdominal pain in the elderly. J Clin Gastroenterol 1994; 19(4): 331-5.
[http://dx.doi.org/10.1097/00004836-199412000-00016] [PMID: 7876517]
[10]
Sherlock DJ. Acute appendicitis in the over-sixty age group. Br J Surg 1985; 72: 245-6.
[http://dx.doi.org/10.1002/bjs.1800720337]
[11]
Lee SL, Walsh AJ, Ho HS. Computed tomography and ultrasonography do not improve and may delay the diagnosis and treatment of acute appendicitis. Arch Surg 2001; 136(5): 556-62.
[http://dx.doi.org/10.1001/archsurg.136.5.556] [PMID: 11343547]
[12]
Guller U, Jain N, Peterson ED, Muhlbaier LH, Eubanks S, Pietrobon R. Laparoscopic appendectomy in the elderly. Surgery 2004; 135(5): 479-88.
[http://dx.doi.org/10.1016/j.surg.2003.12.007] [PMID: 15118584]
[13]
Ko YH, Park SH, Jung CK, et al. Clinical characteristics and prognostic factors for primary appendiceal carcinoma. Asia Pac J Clin Oncol 2010; 6(1): 19-27.
[http://dx.doi.org/10.1111/j.1743-7563.2010.01276.x] [PMID: 20398034]
[14]
Kalpande S, Pandya J, Sharma T. Adenocarcinoma mimicking appendicular lump: A diagnostic dilemma-a case report. World J Surg Oncol 2016; 14(1): 283.
[http://dx.doi.org/10.1186/s12957-016-1036-9] [PMID: 27835997]
[15]
Shami VM, Yerian LM, Waxman I. Adenoma and early stage adenocarcinoma of the appendix: Diagnosis by colonoscopy. Gastrointest Endosc 2004; 59(6): 731-3.
[http://dx.doi.org/10.1016/S0016-5107(04)00008-2] [PMID: 15114326]
[16]
Trivedi AN, Levine EA, Mishra G. Adenocarcinoma of the appendix is rarely detected by colonoscopy. J Gastrointest Surg 2009; 13(4): 668-75.
[http://dx.doi.org/10.1007/s11605-008-0774-6] [PMID: 19089515]
[17]
Jones AE, Phillips AW, Jarvis JR, Sargen K. The value of routine histopathological examination of appendicectomy specimens. BMC Surg 2007; 7: 17.
[http://dx.doi.org/10.1186/1471-2482-7-17] [PMID: 17692116]

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