J Korean Surg Soc.  2009 Jun;76(6):398-402. 10.4174/jkss.2009.76.6.398.

Colon Type Adenocarcinoma of Appendiceal Orifice with Synchronous Colon Cancer and Appendiceal Mucocele

• Kim HU
• Jeong IH
• Kang HW
• Kim JH
• Ko HS

• KMID: 1464958
• DOI: http://doi.org/10.4174/jkss.2009.76.6.398

Abstract

Primary adenocarcinoma of the appendix is an extraordinarily rare tumor, with fewer than 500 cases described in the collected world literature. However, it has been shown that the incidence of secondary neoplasm, such as synchronous or metachronous lesions, for primary adenocarcinoma of the appendix is much greater than that for colorectal cancer in general. In the present paper, the authors report a case of a 72-year-old male patient with immunoreactivity for P 53 and DCC protein and a review of the literature, who was operated on for an appendiceal orifice cancer and in whom colonic adenomas, a synchronous colon cancer and an appendiceal mucocele, was incidentally discovered after right hemicolectomy.

Keyword

Appendiceal cancer; Mucocele; Multiple primary neoplasm

MeSH Terms

Adenocarcinoma
Adenoma
Aged
Appendiceal Neoplasms
Appendix
Colon
Colonic Neoplasms
Colorectal Neoplasms
Humans
Incidence
Male
Mucocele
Neoplasms, Multiple Primary

Figure

• 

  Fig. 1 The specimen. (A) The length of resected colon and cecum is 23 cm and 6 cm, respectively. About 4×3×3 cm sized round polypoid mass is seen on the cecal base (long arrow). About 1.5×0.7×0.5 cm sized ulcerated mass is noticed on the ascending colon (short arrow). Additional small polyps are seen between 1st and 2nd masses (arrow heads). (B) On transverse section of appendix, mass originates from appendix orifice and has short stalk-like structure.

• 

  Fig. 2 Immunohistochemical analysis of the expression of DCC (A, C, E, G and I, ×400) and p53 (B, D, F, H and J, ×200) in appendiceal and colonic adenocarcinoma (A~C and D), adenoma (E and F), appendiceal mucocele (G and H) and normal colonic mucosa (I and J). DCC protein was expressed uniformly in normal colonic crypts and luminal cells with cytoplasmic pattern (I). DCC protein was also expressed in neoplastic lesion including adenocarcinoma (A and C), adenoma (E), and mucocele (G) with more intense staining than normal mucosa (J). P53 over-expression is seen in adenocarcinoma (in more than 75% of tumor cells) (B and D) and adenoma (in 25~50% of tumor cells) (F) contrast to no staining of normal colonic mucosa (J). In mucocele of appendix, a few epithelial cells stained with p53 (G).

Reference

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