Five Csses of Primary Carcinoma of the Vermiform Appendix

Yasuhiro Matsugu, Hirohumi Nakatsuka, Kazuhiro Toyota, Takayuki Ogawa, and Hisashi Ohshiro

Department of Surgery, Kure City Medical Association Hospital

We treated 5 cases of primary carcinoma of the vermiform appendix. The incidence of appendectomy was 5/247 (2.02%) and colorectal cancer resection 5/361 (1.39%) from July 1986 to March 2000 at our hospital. The mean male age (3 cases) and female (2 cases) patients was 59.2 years. Four cases were prediagnosed as acute appendicitis and one as mucocele. Pathological examination showed 3 were well differentiated adenocarcinomas, 1 was cystoadenocarcinoma, and 1 was mucinous carcinoma. Ileocecal resection was conducted in 3 cases and right hemicolectomy in 2. Three cases were treated by additional surgery after appendectomy. Primary carcinoma of the vermiform appendix is rare and preperative diagnosis difficult, so it is important to conduct preoperative X-ray examination, careful intrapoerative inspection, and postoperative pathological examination. Although radical surgery involving lymph node dissection in advanced cancer and appendectomy as routine in early cancers with undefined preoperative diagnosis are common, additional surgery in early cancer should follow procedures designed for advanced cancer if the tumor has invaded the submucosa. Appendectomy is adequate if the tumor has not invaded the marginal layer, and closure of the stump is possoble if tumors are limited to mucosa. With data on these issues not yet available, cases and follow-up sutdies should be collected to detemine appropriate operative procedures in each case.

Key words
adenocarcinoma, early cancer, vermiform appendix

Reprint requests
Yasuhiro Matsugu Department of Surgery, Kure City Medical Association Hospital 15-24 Asahi-machi, Kure city, 737-0056 JAPAN

Accepted
April 25, 2001

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