A CASE OF MUCINOUS CYSTADENOCARCINOMA OF THE APPENDIX FORMING A GIANT APPENDIX

Abstract

A case of mucinous cystadenocarcinoma of the appendix forming a giant appendix that presented difficulty in preoperative diagnosis is reported. An 83-year-old woman was seen at the hospital because of right lower quadrant pain. On the first visit, a fist-sized tumor was palpated in the right lower abdomen. Abdominal CT revealed that an oval tumor existed on the right side in the pelvis, the wall was double-stuructured, and the content was almost water density. It was inferred that the tumor was adjacent to the uterus, bladder, and ileocecal region, but the primary site of the tumor could not be identified. A laparotomy was performed at the department of obstetrics&gynecology in our hospital with a suspicion of ovarian cystoma. During surgery, it was found that both the ovaries and uterus were normal and the tumor was connected to the appendix, when we (surgions) were consulted and confirmed that it was a giant appendix. An appendectomy was carried out. The resected specimen revealed the giant appendix with the whole length of 18cm and 465g in weight containing of jelly-like substance and mucus. Histopathologically, mucinous cystadenocarcinoma was observed at the tip of the appendix. Mucinous cystadenocarcinoma presenting giant appendix is extremely rare. This paper descibes such a rare case wih a review of the literature.