Transvers Kolonda Adenokarsinom ile Senkron Olarak Görülen Appendikste Serrat Adenom: İkisi de Mikrosatellit İnstabilite Negatif

Abstract

Appendix is a rare localization for serrated adenomas. Adenocarcinoma associated with serrated adenoma is a distinct type of colorectal neoplasm, accounting for 5.8% of all colorectal carcinoma cases. A 79-years-old male patient presented with three days of history of generalized abdominal pain, bloating and constipation. Due to the suspicion of intestinal perforation an explorative laparotomy was performed. Gross examination of the subtotal colectomy demonstrated a thickened ulcerated vegetative tumoral mass largest size 5 cm. In serial sections, moderately differentiated adenocarcinoma was seen in transverse colon, and incidentally, a serrated adenoma also was detected in serial sections of appendix. Ki67 was diffusely positive in lower half of the foeveolar structures. Immnohistochemically, MLH-1, PMS-2, MSH-6, MSH-2 were also positive and there was no microsatellite instability in this serrated adenoma of the appendix. In our case, microsatellite instability was not detected in serrated adenoma of the appendix and adenocarcinoma of the colon.