Il mucocele maligno dell’appendice vermiforme. Descrizione di un caso


Luigi Greco, Umberto Papa

Ann. Ital. Chir., 2006; 77: 355-358

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CASE REPORT: The Authors report a case of a 66 years old male patient with mucinous cystoadenocarcinoma of the
appendix. Preoperative diagnosis was appendiceal mucocele. At laparatomy was revealed the presence of a large mass of
the appendix involving the caecum. No mucinous ascites was present and no mucinous implants on the peritoneum surface.
Operation consisted in appendectomy and resection of the caecum bottom. Hystology revealed diagnosis of mucinous
cystoadenocarcinoma of the appendix. After two weeks patient underwent right hemicolectomy, he is alive without disease
at 36 mounths follow up. Mucinous cystic neoplasms of the appendix is an uncommon disease that is rarely suspected
before surgery.
CONCLUSIONS: The Authors stress the importance of an appropriate surgical treatment. Right hemicolectomy appears to
be the appropriate treatment with aggressive debulking when mucinous cystoadenocarcinoma is associated with pseudomyxoma
peritonei. The role of chemotherapy in the treatment of patients with appendiceal cancers remains controversial.
No controlled data on the efficacy of adjuvant chemotherapy are available. All patients with any form of appendiceal
tumor appear to have an increased incidence of synchronous and metachronous neoplasms, especially in the gastrointestinal
tract, and should be investigated and followed up appropriately.