A RESECTED CASE OF PRIMARY CANCER OF THE APPENDIX PRESENTING WITH A HUGE METASTATIC LESION IN THE OVARY

Primary cancer of the appendix is a rare entity. We experienced a patient with the disease who was seen at the hospital because of a lower abdominal tumor and was operated on with a diagnosis of ovarian cancer, but intraoperative frozen section diagnosis resulted in that the ovarian lesion was a metastasis from a cancer of the appendix. This paper describes this rare case with a review of the literature. A 46-year-old woman was admitted to the gynecological & obstetrical department in our hospital because of a lower abdominal tumor. There were an adult's head sized tumor in the lower abdomen, pleural effusion and ascites. Ultrasonography and CT revealed aninternally heterogenous tumor with irregular margin in the ovary. Laparotomy was performed with a diagnosis of ovarian tumor. The tumor existed in the left ovary, and a swelling of the ileocecal lymph nodes and claval hypertrophy of the appendix were noted. In addition intraoperative frozen section diagnosis was ovarian metastasis of signet ring cell carcinoma. The patient was definitely diagnosed as cancer of the appendix with an ovarian metastasis. Excision of the ileocecal region, simple hysterectomy, and bilateral adnexectomy were carried out. The excised specimen revealed mixed-type and moderately differentiated adenocarcinoma arising in the appendix with metastases to the left ovary as well as the uterus and right ovary.