Goblet cell appendiceal adenocarcinoma. How to deal with this rare entity. Case report & review of literature

Abstract

Goblet Cell Adenocarcinoma (GCA) is considered a very rare entity with an incidence of 0.05 cases/100.000 per year. The aim of this report is the presentation of a case of 68-year old male who was diagnosed with GCA with a concomitant review of the recent literature. A 68 year old male presented in ED with a clinical and radiological appearance of acute appendicitis. The patient underwent a laparoscopic appendectomy. Biopsy of the specimen revealed GCA. A right hemicolectomy was performed one month later with an uneventful post-op course, followed by adjuvant chemotherapy due to one positive lymph node. A research on recent literature was performed focusing on clinical presentation, epidemiology, diagnosis, pathology, management and survival of patients with GCA. It revealed that GCA is usually first presented as acute appendicitis with the diagnosis being set only after histology report. It is not yet well established which grading system of colon cancer is more appropriate for this entity. Thus, although right hemicolectomy seems to be the treatment of choice, there are no clear guidelines about the surgical treatment of these patients. The 5 year old survival presents a great fluctuation according to tumor stage but in general it seems to be better than the one of adenocarcinoma of the colon.