A Case of Juvenile Adenocarcinoma of the Vermiform Appendix with Intraluminal Growth of the Cecum

Kazunari Okada, Masayoshi Iwamatsu, Toyohiko Nishino, Kiyone Chikuba, Chikara Shimizu, Toshikazu Matsuo

Department of Surgery and Medicine, Oita Red Cross Hospital

Primary appendiceal carcinoma is a relatively rare disease, for which it is very difficult to obtain a definite diagnosis pre-operatively because it lacks peculiar clinical symptoms. This report describes one patient with primary appendiceal carcinoma which was found to be very rare in terms of the patient's age and the mode of its development. The patient was a l7-year-old woman with a complaint of epigastralgia. Because severe anemia and a tumor in the right lower abdomen were confirmed, a diagnosis of cecal carcinoma was established on the basis of examinations by barium enema and colonofiberscopy. A right hemicolectomy with lymph node dissection of R₃ was performed. Pathohistological examinations of resected samples revealed moderately differentiated adenocarcinoma of the colonic type arising from the appendix which developed inwardly into the lumen of the cecum, while the lymph nodes showed only inflammation. In juvenile patients as well as patients after middle age, it will be necessary to consider the possibility of this disease and conduct examinations, if they have a tumor and/or recurring pain in the right lower abdomen. Furthermore, it is desirable to conduct right hemicolectomy or ileocecal resection with lymph node dissection in patients with primary appendiceal carcinoma.

Key words
carcinoma of the vermiform appendix, juvenile adenocarcinoma of the vermiform appendix, intraluminal growth of the cecum

Reprint requests
Kazunari Okada First Department of Surgery, Medical College of Oita
1-1506 Idaigaoka, Hazama-machi, Oita-gun, Oita 879-56 JAPAN

Accepted
September 12, 1990

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