Introduction. Primary appendiceal adenocarcinoma is a very rare malignancy
which accounts for 0.1% of all appendectomy specimens. In both patients
presented in this paper, appendectomy was performed due to suspected acute
complicated appendicitis. Case Reports. The first patient, a 77-year-old
man, presented with a low grade colonic-type pT3 adenocarcinoma of the
appendix, diagnosed by histopathological examination of the resected
appendix delivered in a fixative. A month after appendectomy, the patient
underwent right hemicolectomy of a tumor at the edge of the resection. Due
to a cardiovascular disease, adjuvant chemotherapy was not indicated. The
second patient, a 74-year-old female, presented with a low grade mucinous
adenocarcinoma of the appendix with subserous infiltration, diagnosed by
histopathological analysis of the resected appendix. Eight months after
appendectomy, the patient developed a recurrent tumor in the cecal area.
After radical surgical excision of the recurrent tumor, the patient received
adjuvant chemotherapy. Both patients had a 5-year survival without relapse.
Conclusion. Preoperative diagnosis of appendiceal adenocarcinoma is a
challenge due to overlapping symptoms of complicated acute appendicitis. Our
results suggest that in elderly patients with symptoms of complicated acute
appendicitis, appendectomy should be done with intraoperative
histopathological frozen section consultation. In advanced stages of
adenocarcinoma, right hemicolectomy is a better choice than appendectomy.
Adenocarcinoma of the appendix mimicking complicated appendicitis in the elderly: A report of two cases
