Acute Appendicitis Caused by Metastases from Squamous Cell Carcinoma of the Lung: A Case Report

Yosuke Tajima, Yasuo Sakai, Kazuhito Yajima, Nobuyuki Musha, Toshihiro Tsubono, Hiroshi Ogawa, Susumu Suzuki and Noriko Ishihara*

Department of Surgery and Department of Pathology*, Niigata Saiseikai Daini Hospital

We report a case of acute appendicitis resulting from metastatic squamous cell carcinoma of the lung. A 71-year-old man with pain in the lower right abdomen, and a medical history including lobectomy of the right lung for squamous cell carcinoma 12 months earlier had a final TNM stage of the original lung cancer of T4N2M0. Physical examination showed severe tenderness and a positive Blumberg sign in the right lower abdominal quadrant. The white blood cell count had markedly increased to 22,000/mm³ and serum C-reactive protein to 9.9 mg/dl. Abdomino-pelvic computed tomography showed a mass in the appendix in the right lower abdominal cavity. Acute appendicitis was tentatively diagnosed, necessitating emergency surgery. At laparotomy, the appendix was found to be perforated and to contain dirty fluid. It was also adhering to the ileum through the upper part, necessitating appendectomy and partial resection of the ileum. Pathological examination showed a metastatic, poorly differentiated squamous cell carcinoma -a finding compatible with the history of lung carcinoma resected 12 months earlier in this patient.

Key words
lung cancer, appendix, appendicitis

Reprint requests
Yasuo Sakai Department of Surgery, Saiseikai Niigata Daini Hospital
280-7 Teraji, Niigata, 950-1104 JAPAN

Accepted
September 27, 2006

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