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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, 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 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 foe pathology lab and a diagnosis of adenocarcinoma of the appendix was made.