A 34-year-old man undergoes an uneventful appendectomy for acute, non perforated appendicitis. The pathology report notes reads: acute inflammation with a 1-cm adenocarcinoma of the mid appendix. This patient should have:
Primary adenocarcinoma of the appendix is rare. Three types of adenocarcinoma exist; mucinous, colonic, and adenocarcinoid. The most common presentation of adenocarcinoma is acute appendicitis. The recommended treatment for all patients diagnosed with adenocarcinoma is a formal right hemicolectomy. Patients are at risk for both synchronous and metachronous neoplasms-half of which will originate in the GI tract.
A 45-year-old woman presents with RLQ pain. A CT scan is performed. What finding on CT scan is most suggestive of appendiceal lymphoma?
Lymphoma of the appendix is uncommon. The most common types of appendiceal lymphoma in decreasing order are non-Hodgkin, Burkitt, and leukemia. Findings on CT scan include appendiceal diameter of >2.5 cm or surrounding soft tissue thickening. The management is confined to appendectomy. Right hemicolectomy is indicated if the tumor extends beyond the appendix onto the cecum or into the mesentery. If requiring a right hemicolectomy, postoperatively the patient will require a staging workup and possible adjuvant chemotherapy.
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