A Case Report of Primary Adenocarcinoma of the Appendix with Perforation and Liver Metastasis

Suguru Sawada and Yutaka Ozeki

Department of Surgery, Tosei National Hospital

A 68-year-old man diagnosed with peritonitis due to perforated acute appendicitis underwent and appendectomy and drainage. The postoperative pathological diagnosis was primary moderately differentiated adenocarcinoma of the appendix. Abdominal CT showed 4 metastatic liver tumors in the right lobe. We followed the man up 3 month after appendectomy. Right hemicolectomy and right hepatic lobectomy were done. The pathological diagnosis was moderately differentiated metastatic adenocarcinoma of the liver and lymph nodes. The man was discharged on post 28 operative day, but died of the recurrence 20 months after the first operation. Primary adenocarcinoma of the appendix is rare, In addition to, as is hepatectomy for liver metastasis. Although the prognosis of primary appendiceal adenocarcinoma with liver metastasis is dismal, aggressive hepatectomy is indicated unless distant metastasis and peritoneal dissemination existed. Hepatectomy after the first operation should be done as soon as the patient's general condition allows.

Key words
appendiceal adenocarcinoma, liver metastasis, hepatectomy

Reprint requests
Suguru Sawada Department of Surgery, Yokohama General Hospital
2201 Kurogane-cho, Aoba-ku, Yokohama, 225-0025 JAPAN

Accepted
June 30, 2004

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