Preoperatively Diagnosed Primary Carcinoma of the Vermiform Appendix due to a Discrepancy between the Laboratory Data and Physical Findings: Report of Two Cases

Maki Takai, Kenkichi Hashimoto, Shota Hasuda, Kiyoshi Kajiyama, Masahiro Tateishi and Soichiro Maekawa

Department of Surgery, Munakata Medical Association Hospital

Vermiform appendix carcinoma is rare and difficult to diagnose preoperatively. We report two cases. Laboratory data in case 1 was WBC of 35,800/mm³ and CRP of 7.1 mg/dl, while that in case 2 was WBC of 10,900/mm³ and CRP of 21.2 mg/dl. Imaging studies suggested abscess due to the perforated appendicitis, but neither showed strong tenderness at the cecum. Colonoscopy showed malignant change at the orifice of the vermiform appendix, leading to a diagnose is carcinoma of the vermiform appendix. We emphasize that among patients with cecal lesion, a discrepancy between laboratory data and physical findings suggests colonoscopy to obtain a definitive preoperative diagnosis of carcinoma of the vermiform appendix.

Key words
primary carcinoma of the vermiform appendix, preoperative diagnosis, colonoscopy

Reprint requests
Maki Takai Department of Surgery, Munakata Medical Association Hospital
5-5-3 Takuma, Munakata, 811-3431 JAPAN

Accepted
October 19, 2005

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