虫垂炎で発症し術前に診断した盲腸癌の１例

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  • A CASE OF CECAL CANCER PRESENTED WITH APPENDICITIS AND DIAGNOSED PREOPERATIVELY

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A 63-year-old woman presented with right lower abdominal pain had a palpable tumor with the size of a tip of the thumb at the same area. Her symptom was once subsided but recurred 19 days later. Although abdominal CT scan visualized abscess at the ileocecal region, colonofiberscopy was carried out for a possibility of colorectal cancer because her general condition was comparatively stable. As a result, a tumor was found at the opening of the appendix, and a pathologist reported that a biopsy resulted in adenocarcinoma. The patient was operated on with a diagnosis of cecal cancer with appendicitis. At laparotomy the appendix with severe inflammation perforated and formed abscess around the organ. The abscess cavity was resected as possible as we could and dissection of group 3lymph nodes was carried out. The resected tumor was 22mm in diameter and type 2, and the opening of the appendix was present at the base of ulcer. Histopathological findings included well, a2, ly1, v2, and n0; the tumor was in stage II and the operation resulted in curability A. The patient developed ileus due to peritoneal dissemination 9 months after surgery, and jejunotransversostomy was performed. Despite chemotherapy, the patient died of cancer 22 months after the initial operation.<br>Possible association of colorectal cancer must be kept in mind in the case of appendicitis in the middle and elderly people.

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