A case report ; mucinous cystadenocarcinoma of the appendix developed from early lesion of the vermiform appendix

Mucinous cystadenocarcinoma of the appendix is rare. Some cases of early carcinoma were reported, but many of them were diagnosed incidentally. In this case, We report a unique picture of the vermiform appendix supposed to be early lesion. A 89-year-old man visited Tochigi Cancer Center complaining of lower abdominal pain. Colonoscopic examination showed the elevated lesion and circular fold around the opening of the vermiform appendix with discharge of mucin. At that time, pathologic examination of the biopsy specimen revealed adenoma. He refused to undergo a surgical resection. Three years later, he was admitted to Jichi Medical School Hospital with the diagnosis of cecal tumor. Colonoscopic examination showed the large tumor covered with mucin and blood in the cecum. He underwent ileocecal resection, and the pathological diagnosis was mucinous cystadenocarcinoma of the appendix. We supposed that such colonoscopic findings as the elevated lesion and circular fold around the opening of the vermiform appendix with discharge of mucin showed early stage of mucinous cystadenocarcinoma of the appendix.