A CASE REPORT OF PRIMARY APPENDICEAL CARCINOMA WITH ELEVATED SERUM CARCINOEMBRYONIC ANTIGEN

A 72-year-old woman was seen at the hospital because of a right lower abdominal pain. Abdominal ultrasonography showed an ileocecal tumor. Barium enema study did not visualize the appendix but demonstrated a polypoid defect of the cecum. Abdominal computed tomography revealed a thickening of wall and a cystic change at the head of cecum. On physical examination, there were tenderness and the egg-sized tumor in the right lower abdomen. Anemia and an elevated serum carcinoembryonic antigen were noted in the laboratory data. The patient was diagnosed as having an appendiceal carcinoma preoperatively and underwent a right hemicolectomy. Microscopic examination showed well differentiated adenocarcinoma of the appendix. No chemotherapy was added. There has been no recurrence, as of two years after the operation. Primary appendiceal carcinomas are rare and account for 0.08% of all resected appendices. As the disease is similar to acute appendicitis, it often presents difficulty in pereoperative diagnosis. We report this case which was successfully diagnosed before operation with a review of the literature.