Tuberculosis of the appendix with coexistent carcinoma- A rare case report

Abstract

An association between chronic granulomatous infection, like tuberculosis and cancer exists, but few studies elucidate the possible mechanism of development. Break in the mucosal barriers with bacterial infection and impaired cell mediated immunity are known to be associated with cancer. Gastrointestinal tuberculosis is common in the ileocecal region, but isolated appendiceal tuberculosis is rare. Cancers of the appendix are rare and most of them are found accidentally on surgical appendicectomy specimens performed for appendicitis. The common appendiceal tumors are carcinoid, adenoma and lymphoma. Adenocarcinoma of the appendix accounts for only 0.08% of all cancers. It usually presents as appendicitis with evident lump or abscess. We present a case of a 42-year-old lady, who presented with symptoms of vague abdominal pain with low grade fever for 4 months and was diagnosed as appendiceal tuberculosis with coexistent mucinous adenocarcinoma of the appendix. Appendicectomy with right hemicolectomy was performed followed by adjuvant chemo-irradiation. She is doing well after 6 months of follow up period. Keywords: Appendix, Adenocarcinoma, Histopathology, Tuberculosis.