A Case of Complete Intussusception Induced by Cancer of the Appendix

Yoshinobu Yokoyama, Hideo Okami, Tetsuji Minamimura* and Kazuhiro Tsukada*

Department of Surgery, Toyama Teishin Hospital
Second Department of Surgery, Toyama University*

We report a case of complete intussusception induced by appendiceal cancer with a review of the literature. A 96-year-old woman seen for melena was found in colonofiberscopy and barium enema to have a cecal tumor. Abdominal computed tomography showed a cecal mass with a target sign. Based on a preoperative diagnosis of intussusception with a cecal tumor, we conducted ileocolectomy. Appendiceal intussusception was found intraoperatively and in the postoperative specimen. Microscopic examination showed well-differentiated adenocarcinoma in tubulovillous adenoma localized to the appendix mucosa. Diagnosis of intussusception with carcinoma of the appendix is often difficult because appendiceal carcinoma is rare. Although this disease can be diagnosed by radiographic imaging, colonoscopy, and computed tomography, it should always be considered in diagnosing diseases of the cecum. Minimal surgical intervention should be performed in the event of failure of recognition of lymph node metastasis, because early cancer and cancer in adenoma are reported to be the most probable reasons for appendiceal intussusceptions caused by appendiceal cancer.

Key words
appendiceal carcinoma, appendiceal intussusception

Reprint requests
Yoshinobu Yokoyama Department of Surgery, Toyama Teishin Hospital
2-2-29 Kashima-cho, Toyama, 930-8798 JAPAN

Accepted
September 16, 2009

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