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Persistent Coughing as the First Symptom of Primary Mucinous Appendiceal Adenocarcinoma.

Gourgiotis S, Oikonomou C, Kollia P, Falidas E, Villias C - J Clin Med Res (2015)

Bottom Line: Furthermore, in many cases, difficulties in establishing an accurate intraoperative diagnosis have resulted in a two-stage surgical intervention.Typical right hemicolectomy was performed and the histopathological examination confirmed mucinous adenocarcinoma of the appendix.As some cases are accidentally discovered, the presented case describes an extremely rare first presentation of this tumor and emphasizes that the preoperative diagnosis of appendiceal cancer is challenging due to the lack of specific symptoms and signs.

View Article: PubMed Central - PubMed

Affiliation: First Surgical Department, 417 NIMTS Military Veterans' Fund Hospital of Athens, Greece.

ABSTRACT
Primary appendiceal adenocarcinomas are extremely rare entities. Preoperative diagnosis is very difficult and is mainly based on computed tomography (CT) scan findings. Furthermore, in many cases, difficulties in establishing an accurate intraoperative diagnosis have resulted in a two-stage surgical intervention. We herein report a case of a primary appendiceal mucinous adenocarcinoma in a 67-year-old Caucasian man who presented with atypical symptoms of persistent coughing and weight loss. The chest CT showed lesions with features favorable of malignancy. Further investigation with abdominal CT and colonoscopy revealed a large tumor of the cecum expanding to the ascending colon. Typical right hemicolectomy was performed and the histopathological examination confirmed mucinous adenocarcinoma of the appendix. As some cases are accidentally discovered, the presented case describes an extremely rare first presentation of this tumor and emphasizes that the preoperative diagnosis of appendiceal cancer is challenging due to the lack of specific symptoms and signs.

No MeSH data available.


Related in: MedlinePlus

The resected specimen of right hemicolectomy.
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Figure 4: The resected specimen of right hemicolectomy.

Mentions: A colonoscopy was performed revealing a large mass in the cecum expanding in the lower portion of the ascending colon (Fig. 3). Biopsies were taken showing adenocarcinoma. Furthermore, the cytological examination of the cells from the bronchoalveolar lavage (BAL) revealed glandular tumor cells. The patient, following oncological council, subjected to neoadjuvant chemoradiation, in accordance with the therapeutic protocol for metastatic adenocarcinoma of colon with non-excludable pulmonary metastasis. Six months later, a right hemicolectomy (Fig. 4) with side-to-side ileocolic anastomosis was performed. Has also be mentioned that no peritoneal metastases were observed in the presented case, although the patient had pulmonary metastases.


Persistent Coughing as the First Symptom of Primary Mucinous Appendiceal Adenocarcinoma.

Gourgiotis S, Oikonomou C, Kollia P, Falidas E, Villias C - J Clin Med Res (2015)

The resected specimen of right hemicolectomy.
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4471756&req=5

Figure 4: The resected specimen of right hemicolectomy.
Mentions: A colonoscopy was performed revealing a large mass in the cecum expanding in the lower portion of the ascending colon (Fig. 3). Biopsies were taken showing adenocarcinoma. Furthermore, the cytological examination of the cells from the bronchoalveolar lavage (BAL) revealed glandular tumor cells. The patient, following oncological council, subjected to neoadjuvant chemoradiation, in accordance with the therapeutic protocol for metastatic adenocarcinoma of colon with non-excludable pulmonary metastasis. Six months later, a right hemicolectomy (Fig. 4) with side-to-side ileocolic anastomosis was performed. Has also be mentioned that no peritoneal metastases were observed in the presented case, although the patient had pulmonary metastases.

Bottom Line: Furthermore, in many cases, difficulties in establishing an accurate intraoperative diagnosis have resulted in a two-stage surgical intervention.Typical right hemicolectomy was performed and the histopathological examination confirmed mucinous adenocarcinoma of the appendix.As some cases are accidentally discovered, the presented case describes an extremely rare first presentation of this tumor and emphasizes that the preoperative diagnosis of appendiceal cancer is challenging due to the lack of specific symptoms and signs.

View Article: PubMed Central - PubMed

Affiliation: First Surgical Department, 417 NIMTS Military Veterans' Fund Hospital of Athens, Greece.

ABSTRACT
Primary appendiceal adenocarcinomas are extremely rare entities. Preoperative diagnosis is very difficult and is mainly based on computed tomography (CT) scan findings. Furthermore, in many cases, difficulties in establishing an accurate intraoperative diagnosis have resulted in a two-stage surgical intervention. We herein report a case of a primary appendiceal mucinous adenocarcinoma in a 67-year-old Caucasian man who presented with atypical symptoms of persistent coughing and weight loss. The chest CT showed lesions with features favorable of malignancy. Further investigation with abdominal CT and colonoscopy revealed a large tumor of the cecum expanding to the ascending colon. Typical right hemicolectomy was performed and the histopathological examination confirmed mucinous adenocarcinoma of the appendix. As some cases are accidentally discovered, the presented case describes an extremely rare first presentation of this tumor and emphasizes that the preoperative diagnosis of appendiceal cancer is challenging due to the lack of specific symptoms and signs.

No MeSH data available.


Related in: MedlinePlus