A Case of Acute Appendicitis Caused by Metastatic Carcinoma of the Stomach

Tatsuo Tanaka, Hiroyuki Konno, Yuji Maruo, Nobuhiko Nishino, Iwao Matsuda, Katsunori Aoki, Syozo Baba

Second Department of Surgery, Hamamatsu University, School of Medicine

Metastatic appendiceal cancer is rare; only 16 cases have been reported in Japan. A case of appendiceal metastasis of gastric cancer is presented. A 76-year-old man, who had undergone gastrectomy for Borrmann type-3 gastric cancer 4.5 years earlier, was admitted to our department because of high fever and lower abdominal pain. Appendectomy was performed under a diagnosis of acute appendicitis. At the operation no sign of recurrence including peritoneal dissemination was observed, and the macroscopic appearance of the appendix was consistent with gangrenous appendicitis. However, histological examination showed many small foci of poorly differentiated adenocarcinoma, in part of which adenotubular structures were observed. Therefore, he was diagnosed histologically as having appendiceal metastasis of gastric cancer. The patient has survived without recurrence for two years and one month after the appendectomy. When cancer patients have symptoms compatible with appendicitis, metastatic appendiceal cancer should always be considered.

Key words
appendiceal metastasis of gastric cancer, acute appendicitis caused by metastatic carcinoma

Reprint requests
Tatsuo Tanaka Second Department of Surgery, Hamamatsu University, School of Medicine
3600 Handa-cho, Hamamatsu, 431-31 JAPAN

Accepted
July 6, 1992

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