Quick Case: Adenocarcinoid of Appendix in a 34-year-old Female

A 34-year-old woman underwent an operation for recurrent appendicitis. She was suffering from frequent pain and a vague lump feeling in the right iliac fossa region for the last 3 years. However, histopathology of the appendix showed the peculiar hybrid tumor with luminal well-differentiated mucinous adenocarcinoma component, well demarcated from serosal and intramural carcinoid tumor (see photomicrograph figure below). It was purely an incidental finding.

The mucinous adenocarcinoma component had already invaded the peritoneum with organizing abscess formation. Six months after surgery, the patient presented with ascites, which was positive for mucinous carcinoma. Exploratory laparotomy and peritoneal toileting were done, which also confirmed extensive peritoneal adenomucinosis and extensive tumor deposits. The patient died two years after primary surgery, due to extensive refractory metastatic disease. No metastasis of the carcinoid component was found.

hybrid tumor

The peculiar hybrid tumor with luminal well differentiated mucinous adenocarcinoma component well demarcated from serosal and intramural carcinoid tumor.

Learning Points/Take Home Messages

Mucinous carcinoma of the appendix is more common than it is thought. It may co-exist with carcinoid, and in that case it determines the fate of the patient!

About The Author

Dr. Samanta, MBBS, MD is currently a consultant at EKO Diagnostic PVT. LTD. Kolkata, India for histopath, cytopath and hematology. His other interests are: oncopathology, bone marrow and neuropathology.


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