A Case of Primary Signet Ring Cell Carcinoma of the Vermiform Appendix

Yasumitsu Hirano, Hiroshi Nozawa, Makoto Hirano, Takuo Hara, Koichi Nakada, Kaeko Oyama, Naohiro Ohta, Masahiro Hada, Takeshi Takagi and Hideki Niwa*

Department of Surgery and Department of Pathology*, Kouseiren Takaoka Hospital

A 66-year old man was admitted our hospital for right lower abdominal pain. Blood examination showed leukocytosis (WBC count 16,500 /mm³), and the C reactive protein (CRP) level was elevated (18.9 mg/dl), Abdominal ultrasonography showed a swollen appendix. Appendectomy was performed for a preoperative diagnosis of acute appendicitis, and pathological examination of the resected appendix showed signet ring carcinoma. Laparoscopic ileocecal resection with lymph node dissection was performed 53 days later. No residual tumor or lymph nodes metastasis were detected. The patient received postoperative chemotherapy and has remained in good health without clinical evidence of recurrent disease. It is very important to closely examine the resected appendix, including histologically, to avoid missing appendiceal tumors.

Key words
signet ring cell carcinoma, primary appendiceal carcinoma

Reprint requests
Yasumitsu Hirano Department of General and Cardiothoracic Surgery, Kanazawa University School of Medicine
13-1 Takara-machi, Kanazawa, 920-8641 JAPAN

Accepted
September 28, 2005

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