Intramucosal goblet cell adenocarcinoma: The evil got nipped in the bud

Abstract

Introduction: Appendiceal goblet cell adenocarcinoma is a rare cancer that usually has histological features of both well-differentiated carcinoid tumors and adenocarcinomas (neuroendocrine cells are not required for the diagnosis). Appendiceal goblet cell adenocarcinoma can present as acute appendicitis, abdominal pain, a mass, or be discovered incidentally following appendectomy. Case Report: A 67-year-old female presented with signs of acute appendicitis and underwent laparoscopic appendectomy. Pathological evaluation showed evidence of both acute appendicitis/periappendicitis and an incidental appendiceal intramucosal well-differentiated adenocarcinoma in the lamina propria of a 12 mm long segment in the middle of the proximal half of the appendix. Conclusion: Appendiceal goblet cell adenocarcinoma can sometimes be an incidental finding. It can be difficult to identify it, especially when it is in the form of only a few cells and clusters of cells limited to lamina propria. This case is the first reported incidence of an intramucosal goblet cell adenocarcinoma that was present in a 12 mm long segment in the middle of the proximal half of the appendix. The location of this tumor provides justification for making submission of an appendix in its entirety for histologic examination as a standard-of-care.