Appendiceal mucinous cystadenocarcinoma with implantation metastasis to the incision scar and cutaneous fistula.

Igor Mishin, Gheorghe Ghidirim, Marin Vozian

First Department of Surgery N. Anestiadi & Laboratory of Hepato-Pancreato-Biliary Surgery, Medical University N. Testemitsanu, National Center of Emergency Medicine, Kishinev, Moldova. mishin_igor@mail.ru

Journal of gastrointestinal cancer 2012 Jun

filter terms:

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. 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. 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.

Citation

Igor Mishin, Gheorghe Ghidirim, Marin Vozian. Appendiceal mucinous cystadenocarcinoma with implantation metastasis to the incision scar and cutaneous fistula. Journal of gastrointestinal cancer. 2012 Jun;43(2):349-53