TWO CASES OF PRIMARY CARCINOMA OF THE VERMIFORM APPENDIX

Primary carcinoma of the vermiform appendix is a rare disease, and its preoperative diagnosis is difficult. We suspected this condition preoperatively in 2 cases and demonstrated its concurrence with a gallbladder carcinoma in one of them.Case 1 was a 49-year-old female with the chief complaint of right lower abdominal pain. A mass was palpated in this region, and barium enema studies revealed a filling defect in the cecum. Ultrasound examination of the abdomen showed a cystic pattern, and the CT image of the mass was cold in the center and well enhanced in the margins. From these findings, appendicular tumor was suspected, and ileocecectomy (R2) was performed. Pathologic examinations indicated a diagnosis of mucinous cystadenocarcinoma.Case 2 was an 83-year-old female. A gallbladder tumor was detected during close evaluation of unexplained fever. Barium enema studies for staging of this tumor showed a filling defect in the cecum. suggesting a concurrence of appendicular tumor. Cholecystectomy and right colectomy (R2) were carried out. Pathologic diagnosis was well differentiated adenocarcinoma for the gallbladder tumor and mucinous cystadenocarcinoma for the appendicular tumor.