Metastatic gastric adenocarcinoma and synchronous carcinoid tumour mimicking appendicitis: A case report

International Journal of Surgery Case Reports
Q B TranB Strekozov

Abstract

Silent metastatic gastric adenocarcinoma presenting as appendicitis is very rare. Rare pathologies may be encountered during common operations such as appendicectomy and an awareness of possible alternative pathological entities would be helpful in a surgeon's wealth of knowledge. A 63-year-old man presented with a three-day history of acute abdominal pain suggestive of appendicitis. Intra-operatively, a macroscopically inflamed and perforated appendix was found. There were however some atypical features, which included multiple inflamed ulcerated lesions throughout the small bowel mesentery and along the terminal ileum. Appendicectomy was performed and biopsies of these lesions were taken. Subsequent histopathology revealed that there were metastatic deposits of poorly differentiated adenocarcinoma in the appendix and mesenteric biopsies, as well as a neuroendocrine (carcinoid) tumour of the appendix. Upper endoscopy confirmed a gastric primary leading to peritoneal dissemination. The patient was scheduled to undergo a course of palliative chemotherapy. Metastatic gastric adenocarcinomas with peritoneal dissemination have a very poor prognosis and often the first choice of treatment is chemotherapy as a complete cure through s...Continue Reading

Methods Mentioned

BETA
biopsies
biopsy

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