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Primary Appendicular Malignancy Presenting as Abdominal Wall Abscess with Secondary Tuberculosis Infection: an Interesting Case Report

  • Ritim Ravi Patel
  • Vipul Versi Nandu
Case Report
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Abstract

Cancers of the appendix are rare. Most of them are found accidentally on appendectomies performed for appendicitis. When reviewed, majority of the tumors were carcinoid, adenoma, and lymphoma. Adenocarcinomas of the appendix are only 0.08% of all cancers, and the treatment remains controversial. It can present as appendicitis or lump or abscess. Gastrointestinal tuberculosis most commonly involves the ileocecal region. Disruption of the integrity of mucosal barriers and impairment in cell-mediated immunity associated with cancerous growth are known to predispose to bacterial infection. The role of antituberculosis therapy and chemotherapy is unclear due to lacking randomized trials but seems to be accepted if there is lymph node involvement or peritoneal seeding. Here, we are reporting a 69-year-old lady presented with symptoms of abdominal wall abscess with tuberculosis infection which was then diagnosed with mucinous adenocarcinoma of the appendix. The patient was treated with incision and drainage followed by the right hemicolectomy. Up to date, she remains asymptomatic and continuing with chemotherapy.

Keywords

Abdominal wall abscess Adenocarcinoma of appendix Secondary kochs infection 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    McCusker ME, Coté TR, Clegg LX, Sobin LH (2002) Primary malignant neoplasms of the appendix: a population-based study from the surveillance, epidemiology and end-results program, 1973-1998. Cancer 94(12):3307–3312Google Scholar
  2. 2.
    Okita A, Kubo Y, Tanada M, Kurita A, Takashima S (2007) Unusual abscesses associated with colon cancer: report of three cases. Acta Med Okayama 61(2):107–113PubMedGoogle Scholar
  3. 3.
    Sugarbaker PH (1999) Successful management of microscopic residual disease in large bowel cancer. Cancer Chemother Pharmacol 43(Suppl):S15–S25CrossRefPubMedGoogle Scholar
  4. 4.
    Cerame MA (1988) A 25-year review of adenocarcinoma of the appendix. A frequently perforating carcinoma Dis Colon Rectum 31(2):145–150CrossRefPubMedGoogle Scholar
  5. 5.
    Kriwanek S, Armbruster C, Dittrich K, Beckerhinn P (1996) Perforated colorectal cancer. Dis Colon Rectum 39(12):1409–1414CrossRefPubMedGoogle Scholar
  6. 6.
    Alcobendas F, Jorba R, Poves I, Busquets J, Engel A, Jaurrieta E (2000) Perforated colonic cancer. Evolution and prognosis Rev Esp Enferm Dig 92(5):326–333PubMedGoogle Scholar
  7. 7.
    Tanaka K, Kondo S, Hattori F, Yamashita Y, Matsuda M, Itoh K et al (1987) A case of colonic carcinoma associated with intestinal tuberculosis, and an analysis of 26 cases reported in Japan. Gan No Rinsho. 33(9):1117–1123PubMedGoogle Scholar
  8. 8.
    Jain BK, Chandra SS, Narasimhan R, Ananthakrishnan N, Mehta RB (1991) Coexisting tuberculosis and carcinoma of the colon. Aust N Z J Surg 61(11):828–831CrossRefPubMedGoogle Scholar
  9. 9.
    Maruta K, Tanaka S, Nakamura T, Hagio S, Sato E, Nishi M (1983) Carcinoma of the colon coexisting with tuberculosis--report of 2 cases. Gan No Rinsho 29(5):448–453PubMedGoogle Scholar
  10. 10.
    Bresalier R.S. KYS. Malignant neoplasms of the large and small intestine. 4th ed. Sleisenger FJS, editor. Philadelphia: W.B. Saunders; 1989Google Scholar
  11. 11.
    Restrepo LM, Barrera LF, Garcia LF (1990) Natural killer cell activity in patients with pulmonary tuberculosis and in healthy controls. Tubercle 71(2):95–102CrossRefPubMedGoogle Scholar
  12. 12.
    Rao VV, Gupta EV, Thomas IM (1990) Chromosome damage in untreated tuberculosis patients. Tubercle. 71(3):169–172CrossRefPubMedGoogle Scholar
  13. 13.
    Potter JD (1992) Reconciling the epidemiology, physiology, and molecular biology of colon cancer. JAMA 268(12):1573–1577CrossRefPubMedGoogle Scholar
  14. 14.
    Brown CV, Abrishami M, Muller M, Velmahos GC (2003) Appendiceal abscess: immediate operation or percutaneous drainage? Am Surg 69(10):829–832PubMedGoogle Scholar
  15. 15.
    Lasson A, Lundagårds J, Lorén I, Nilsson PE (2002) Appendiceal abscesses: primary percutaneous drainage and selective interval appendicectomy. Eur J Surg 168(5):264–269CrossRefPubMedGoogle Scholar
  16. 16.
    Zarba Meli E, Mazzocchi P, Lepiane P, Dalsasso G, Giacovazzo F, Salvio A, et al. [The role of surgery in the treatment of appendicular abscesses]. Minerva Chir 1997;52(5):577–581Google Scholar
  17. 17.
    Poon RT, Chu KW (1999) Inflammatory cecal masses in patients presenting with appendicitis. World J Surg 23(7):713–716 discussion 6CrossRefPubMedGoogle Scholar
  18. 18.
    Cirocco WC (2005) Right hemicolectomy remains the treatment of choice for adenocarcinoma of the appendix. Gastrointest Endosc 61(6):791 author reply 2CrossRefPubMedGoogle Scholar
  19. 19.
    Nitecki SS, Wolff BG, Schlinkert R, Sarr MG (1994) The natural history of surgically treated primary adenocarcinoma of the appendix. Ann Surg 219(1):51–57CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Pickhardt PJ, Levy AD, Rohrmann CA, Kende AI (2003) Primary neoplasms of the appendix: radiologic spectrum of disease with pathologic correlation. Radiographics 23(3):645–662CrossRefPubMedGoogle Scholar
  21. 21.
    Hartley JE, Drew PJ, Qureshi A, MacDonald A, Monson JR (1996) Primary adenocarcinoma of the appendix. J R Soc Med 89(2):111P–113PCrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Ferro M, Anthony PP (1985) Adenocarcinoma of the appendix. Dis Colon Rectum 28(6):457–459CrossRefPubMedGoogle Scholar
  23. 23.
    Modlin IM, Sandor A (1997) An analysis of 8305 cases of carcinoid tumors. Cancer 79(4):813–829CrossRefPubMedGoogle Scholar
  24. 24.
    Sugarbaker PH, Kern K, Lack E (1987) Malignant pseudomyxoma peritonei of colonic origin. Natural history and presentation of a curative approach to treatment Dis Colon Rectum 30(10):772–779PubMedGoogle Scholar
  25. 25.
    Pahlavan PS, Kanthan R (2005) Goblet cell carcinoid of the appendix. World J Surg Oncol 3:36CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Indian Association of Surgical Oncology 2018

Authors and Affiliations

  1. 1.Parvarish Nursing HomeMumbaiIndia
  2. 2.Department of General SurgeryDr. R.N. Cooper HospitalMumbaiIndia

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