A 62 years old woman , with acute right lower quadrant abdominal pain and leukocytosis.
VIDEO US: Transabdominal ultrasound shows acute appendicitis with peritoneal effusion , irregular and marked tickening of caecum walls with eccentric stenosis with “ pseudo kidney “ pattern as shown in the intestinal neoplasm.
CT : CECT confirms diffuse tickening of caecum walls with marked enhancement consistent with neoplastic pattern . Flogistic tickening of appendix walls with peritoneal effusion. There is also tickening of perilesional fat and concomitant lymph nodes enlargement near right colic artery.
GROSS PATHOLOGIC AND SURGICAL FEATURES: The patient undergoes surgical resection of terminal ileum , caecum with appendix and short segment of ascending colon. The gross morphologic features of neoplasm is large and bulky with polypoid configuration. The appendix is adherent to caecum with flogistic feature. Hystology shows adenocarcinoma with moderately differentiated glands without mucin production , invasion throught the muscolaris propria into subsierosa , absence of lymph node metastasis ( pT3 N0 ).
ADENOCARCINOMA OF THE CAECUM AND SUPPURATIVE APPENDICITIS
Author:
.Danilo Sirigu MD;
Servizio di Radiologia, Azienda Ospedaliera Brotzu, Cagliari
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