Case series on high grade appendiceal cancer with peritoneal and liver carcinomatosis undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC)

Signet ring cell carcinoma of the appendix and terminal ileum: A case report

BACKGROUND

Appendiceal signet-ring cell carcinoma (SRCC) with terminal ileum metastasis is extremely rare. There have been no reported cases in domestic and foreign literature.

CASE SUMMARY

In this case report, we present an 88-year-old man with appendiceal SRCC with terminal ileum metastasis. The tumour stage was stage pT4bN2M1bG3 IVB, and the Tumour, Node, Metastasis staging system was used. The patient was admitted to our hospital on 12 July, 2022 and underwent laparoscopic appendectomy under general anaesthesia after the examination. The pathological examination that took place 1 week after the operation showed that SRCC of the appendix invaded the whole layer, vessels and nerves of the appendix wall. It was suggested that the primary appendix should be considered after excluding metastasis. Based on the postoperative pathology findings, the patient underwent a secondary surgery on 2 August, 2022. The second pathological examination showed residual SRCC in the appendiceal area of the ileocecal region, which infiltrated the serosal fibres and adipose tissue of the ileocecal region to the surface mesothelium. The tumour infiltrated the whole layer of the ileum wall, serosa fibres, adipose tissue and the surface mesothelium. Postoperative follow-up showed no signs of tumour recurrence or metastasis.

CONCLUSION

In clinical practice, a heightened awareness of rare diseases, coupled with thorough intraoperative exploration and rapid pathological examination, enables more accurate judgments, potentially sparing patients from unnecessary secondary surgery and ensuring optimal treatment.

Cerebral Metastases in Appendiceal Cancer: Comprehensive Review and Report of Rare Medullary Carcinoma Histology

Appendiceal cancer is an extremely rare malignancy, and its metastatic spread to the brain is even more unusual. We describe a 47-year-old female who presented with a rare cerebral appendiceal carcinoma metastasis, a case that is further remarkable for representing the first histologic diagnosis of primary medullary carcinoma in the appendix. Based on a comprehensive review of the English literature using PubMed, Embase, and Google Scholar, only six other cases of cerebral appendiceal metastases have been described.