Appendiceal Mucinous Cystadenocarcinoma with Implantation Metastasis to the Incision Scar and Cutaneous Fistula

Overview

Journal J Gastrointest Cancer

Publisher Springer

Specialties Gastroenterology
Oncology

Date 2010 Jun 30

PMID 20585997

Citations 4

Authors

Igor Mishin

Gheorghe Ghidirim

Marin Vozian

Affiliations

Soon will be listed here.

Abstract

Introduction: Mucinous cystadenocarcinoma of the appendix with invasion of the anterior abdominal wall and cutaneous fistula development is a rare condition. To the best of the authors' knowledge, five such cases have been reported in the medical literature.

Methods And Results: The patient was a 68-year-old man who presented with a mass growing through the incisional scar and a skin fistula with mucinous discharge 1 year after appendectomy via McBurney's incision. Carcinoembroyonic antigen and carbohydrate antigen 19-9 concentration was elevated. Abdominal computed tomography scan revealed a mass in the cecum with involvement of the abdominal wall. Right hemicolectomy with en bloc abdominal wall implant and skin fistula resection with clear margins was performed.

Discussion: The patient received intraperitoneal intra- and postoperative chemotherapy. Gross examination of the specimen showed a mass emerging from the remnant stump of the appendix. The patient showed no relapse 1 year after surgery. Clinical, paraclinical features, and treatment options are discussed with review of the literature.

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References

Taii A, Sakagami J, Shinoda M, Taniguchi H, Tosa M, Baba T . Pseudomyxoma peritonei occurring after an uneventful 23 years interval from appendectomy. Intern Med. 2007; 46(14):1109-12. DOI: 10.2169/internalmedicine.46.0079. View

Fann J, Vierra M, Fisher D, OBERHELMAN Jr H, Cobb L . Pseudomyxoma peritonei. Surg Gynecol Obstet. 1993; 177(5):441-7. View

Solkar M, Khan M, Parker M . Pseudomyxoma peritonei confined to the retroperitoneum occurring 35 years after appendicectomy. Int J Colorectal Dis. 2004; 19(4):399-400. DOI: 10.1007/s00384-004-0603-7. View

Miner T, Shia J, Jaques D, Klimstra D, Brennan M, Coit D . Long-term survival following treatment of pseudomyxoma peritonei: an analysis of surgical therapy. Ann Surg. 2005; 241(2):300-8. PMC: 1356916. DOI: 10.1097/01.sla.0000152015.76731.1f. View

Ledesma E, Tseng M, Mittelman A . Surgical treatment of isolated abdominal wall metastasis in colorectal cancer. Cancer. 1982; 50(9):1884-7. DOI: 10.1002/1097-0142(19821101)50:9<1884::aid-cncr2820500939>3.0.co;2-6. View

Keynes W . Implantation from the bowel lumen in cancer of the large intestine. Ann Surg. 1961; 153:357-64. PMC: 1613943. DOI: 10.1097/00000658-196103000-00003. View

Hughes E, McDermott F, Polglase A, Johnson W . Tumor recurrence in the abdominal wall scar tissue after large-bowel cancer surgery. Dis Colon Rectum. 1983; 26(9):571-2. DOI: 10.1007/BF02552962. View

Lim H, Lee W, Kim S, Kim B, Cho J, Byun J . Primary mucinous cystadenocarcinoma of the appendix: CT findings. AJR Am J Roentgenol. 1999; 173(4):1071-4. DOI: 10.2214/ajr.173.4.10511181. View

Johnson M, Jyotibasu D, Ravichandran P, Jeswanth S, Kannan D, Surendran R . Retention mucocele of distal viable remnant tip of appendix: an unusually rare late surgical complication following incomplete appendectomy. World J Gastroenterol. 2006; 12(3):489-92. PMC: 4066076. DOI: 10.3748/wjg.v12.i3.489. View

10.

Gough D, Donohue J, SCHUTT A, Gonchoroff N, Goellner J, WILSON T . Pseudomyxoma peritonei. Long-term patient survival with an aggressive regional approach. Ann Surg. 1994; 219(2):112-9. PMC: 1243112. DOI: 10.1097/00000658-199402000-00002. View

11.

Lo N, Sarr M . Mucinous cystadenocarcinoma of the appendix. The controversy persists: a review. Hepatogastroenterology. 2003; 50(50):432-7. View

12.

El Sayed S . Pseudomyxoma peritonei treated by radiotherapy. Clin Oncol (R Coll Radiol). 1990; 2(2):120-2. DOI: 10.1016/s0936-6555(05)80801-5. View

13.

Arly K, Stephenson Jr D, Davis W . Giant retroperitoneal mucocele simulating pseudomyxoma peritonei and mucinous adenocarcinoma. Am J Surg. 1968; 116(3):439-43. DOI: 10.1016/0002-9610(68)90238-9. View

14.

Reilly W, Nelson H, Schroeder G, Wieand H, Bolton J, Oconnell M . Wound recurrence following conventional treatment of colorectal cancer. A rare but perhaps underestimated problem. Dis Colon Rectum. 1996; 39(2):200-7. DOI: 10.1007/BF02068076. View

15.

Koizumi J, Noguchi H . Pseudomyxoma retroperitonei with spontaneous skin fistula. Abdom Imaging. 1999; 24(2):193-5. DOI: 10.1007/s002619900475. View

16.

Landen S, Bertrand C, Maddern G, Herman D, Pourbaix A, de Neve A . Appendiceal mucoceles and pseudomyxoma peritonei. Surg Gynecol Obstet. 1992; 175(5):401-4. View

17.

van Ruth S, Acherman Y, van de Vijver M, Hart A, Verwaal V, Zoetmulder F . Pseudomyxoma peritonei: a review of 62 cases. Eur J Surg Oncol. 2003; 29(8):682-8. DOI: 10.1016/s0748-7983(03)00149-5. View

18.

Zissin R, Gayer G, Kots E, Apter S, Peri M, Shapiro-Feinberg M . Imaging of mucocoele of the appendix with emphasis on the CT findings: a report of 10 cases. Clin Radiol. 2000; 54(12):826-32. DOI: 10.1016/s0009-9260(99)90687-6. View

19.

Koea J, Lanouette N, Paty P, Guillem J, Cohen A . Abdominal wall recurrence after colorectal resection for cancer. Dis Colon Rectum. 2000; 43(5):628-32. DOI: 10.1007/BF02235576. View

20.

Nakao A, Sato S, Nakashima A, Nabeyama A, Tanaka N . Appendiceal mucocele of mucinous cystadenocarcinoma with a cutaneous fistula. J Int Med Res. 2002; 30(4):452-6. DOI: 10.1177/147323000203000416. View