Leiomyosarcoma of the appendix: report of two cases.
Two cases of leiomyosarcoma of the appendix are reported. Leiomyosarcoma of the large intestine is rare, and leiomyosarcoma of the appendix has not been previously reported.
Appendiceal Neoplasms↗
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Unsuspected perforated adenocarcinoma of the appendix as a second colonic neoplasm: report of a case.
The case of a patient who had an unsuspected perforated adenocarcinoma of the appendix discovered during operation for a sigmoid carcinoma is presented. The problems in diagnosing carcinoma of the appendix are discussed and the literature is reviewed.
Adenocarcinoma↗
Adenocarcinoma of the appendix: a clinicopathologic study.
Clinicopathologic correlation and survival were evaluated in 11 patients with adenocarcinomas of the appendix. This extremely rare tumor was seen most often in patients in the fifth decade of life. Acute appendicitis was the most common mode of presentation (8/11). A few patients (3/11) showed signs of distant metastases from an occult primary tumor in the appendix.
Adenocarcinoma↗
Carcinoma in situ of the vermiform appendix associated with adenomatosis of the colon.
A case is reported of carcinoma in situ of the vermiform appendix associated with adenomatosis of the colon. Histologic examination revealed the presence of tubulovillous adenocarcinoma in an adenoma. Other lesions associated with this neoplasm were multiple adenomatous polyps in the colon and duodenum and two fibromas in the neck. Since the vermiform appendix is a part of the large intestine, it should be expected that careful examination may reveal the adenomatous involvement and may lead to the discovery of carcinoma in situ.
Adenocarcinoma↗
Villous adenoma of the appendix: report of a case and review of the literature.
This report presents a case of a 23-year-old white woman who presented with symptoms of acute appendicitis, confirmed at laparotomy. The appendectomy specimen revealed an isolated, noninvasive villous adenoma of the appendix. Appendectomy was judged to be sufficient treatment in this case since the base of the organ was not involved, and there was no submucosal spread of the villous adenoma. Literature on the subject is reviewed, and modalities of surgical treatment of "invasive" villous adenoma of the appendix are discussed.
Adenoma↗
Superficial spreading adenocarcinoma of appendix, cecum, and terminal ileum.
A case of superficial spreading adenocarcinoma involving terminal ileum, appendix and cecum is presented. The tumor might primarily arise from the proximal part of the appendix with extension to the cecum and terminal ileum, although multicentric origin of the tumor cannot be excluded. The mechanism underlying superficial infiltration of the tumor is through close contact and intramucosal lymphatic spread.
Adenocarcinoma↗
Perforation of the appendix in the neonatal period.
Perforation of the appendix in the neonatal period may be a complication of neonatal necrotizing enterocolitis and should be differentiated from perforating appendicitis in later life. A patient is presented together with a review of the literature to illustrate this concept. Perforation of the appendix occurred in a 12-day-old preterm baby. Th cause of this perforation is assumed to be localized full thickness necrosis of the appendiceal wall, a form of neonatal necrotizing enterocolitis. The similarity between the clinical histories of neonates with so called "appendicitis" and those with necrotizing enterocolitis is pointed out. It is argued that "idiopathic primary peritonitis" probably does not exist, but that the peritonitis may be secondary to similar small perforations of the bowel. The importance of a thorough search for such a perforation is stressed.
Appendicitis↗
Adenocarcinoma of the appendix penetrating the bladder.
We report a case of a mucous papillary tumor in the bladder. Initial treatment was transurethral resection but open partial bladder resection became necessary. Operation revealed an appendix tumor penetrating the bladder. Histologically, it was primary adenocarcinoma of the appendix.
Adenocarcinoma, Papillary↗
Primary carcinoma of the appendix.
Primary adenocarcinoma of the appendix is rare and less than 200 cases are on record. The present material consisted of 20 cases collected from different hospitals. The cases are described in respect of sex and age-distribution, symptoms, treatment and prognosis. Of 7 patients with malignant mucocele, 6 subjected to appendectomy only, were still alive 5 years after the operation. Of 12 patients with colonic type of adenocarcinoma, 3 had been treated with appendectomy only. Of these, 2 were still alive 5 years after the operation. The remaining 9 patients had undergone right hemicolectomy. Only one of them was alive 5 years after the operation. A compilation of a further 39 cases garnered from the literature, however, showed that 60% had survived at least 5 years after right hemicolectomy, compared with 46% after appendectomy alone. Appendectomy alone is probably a sufficiently radical operation for malignant mucocele provided the tumor has not grown through the submucosa and that it is confined to the tip of the appendix. Right hemicolectomy is indicated for the colonic type of adenocarcinoma.
Adenocarcinoma↗
Bacterial studies of peritoneal cavity and postoperative surgical wound drainage following perforated appendix in children.
This study reports bacterial specimens obtained from 112 children presenting with a ruptured appendix. Additional samples were studied from 11 of these patients who developed a postoperative surgical draining wound. Bacterial growth occurred in 100 peritoneal fluid specimens. Anaerobic bacteria alone were present in 14 specimens, aerobes alone in 12, and mixed aerobic an anerobic flora in 74 specimens. There were 144 aerobic isolates (1.4 per specimen). The predominant isolates were: E. coli (57 specimens); alpha-hemolytic steptococcus (16 specimens); gamma-hemolytic streptococcus (15 specimens); Group D streptococcus (12 specimens); and P. aeruginosa (9 specimens). There were 301 anaerobic isolates (three per specimen). The predominant isolates were: 157 Bacteroides spp. (including 92 B. fragilis group and 26 B. melaninogenicus group); 62 gram-positive anaerobic cocci (including 30 Peptococcus sp.; 29 Peptostreptococcus sp.); 27 Fusobactenium sp.; and 16 Clostridium sp. B. fragilis and Peptococcus sp. occurred in 23 patients. Beta lactamase production was detectable in 98 isolates recovered from 74 patients. These included all isolates of B. fragilis and six of the 23 Bacteroides sp. Forty-nine organisms (16 aerobic and 33 anaerobic) were recovered from the draining wounds. The predominant organisms were: B. fragilis (8 specimens); E. coli (6 specimens); Peptostreptococcus sp. (5 specimens); and three specimens each of P. aeruginosa and Peptococcus sp. Most of these isolates were also recovered from the peritoneal cavity of the patients. These findings demonstrate the polymicrobial aerobic and anaerobic nature of peritoneal cavity and postoperative wound flora in children with perforated appendix, and demonstrate the presence of beta lactamase-producing organisms in three-fourths of the patients.
Appendectomy↗
Clinical significance of mucosal inflammation of the vermiform appendix.
In 942 emergency appendectomies, the clinical data of 77 patients with inflammatory changes confined to the mucosa of the vermiform appendix were compared with data from 622 patients with diffuse acute appendicitis and 243 patients without evidence of inflammation in the appendix. In all cases, routine histologic sections of the specimens were reviewed. Of the 77 patients with mucosal appendiceal inflammation, 50 were female and 50% were under 17 years of age. In several clinical aspects, such as incidence of nausea, vomiting, migration of pain, and localized muscular rigidity, there existed significant differences between patients with mucosal inflammation and patients with diffuse appendicitis. Conversely, no statistically significant differences were found between patients with mucosal inflammation and patients without evident appendiceal inflammation. These results in addition to the frequent finding of histologically indistinguishable changes in appendices removed incidentally suggest that the condition is not responsible for the actual complaint.
Adolescent↗
Primary adenocarcinoma of the appendix.
A case of primary adenocarcinoma of the appendix in which the patient had the usual symptoms of acute appendicitis is presented. A review of the literature showed the potential for early extension and nodal metastasis in this lesion and led to the recommendation of right hemicolectomy as the treatment of choice. The operation should be done either primarily or secondarily after an appendectomy and should lead to a five-year survival of approximately 45%. Every effort should be made to make the diagnosis and provide definitive treatment at the primary operation by examining the appendix grossly and obtaining frozen section microscopic study of any suspicious tumor or ulceration.
Adenocarcinoma↗
Leiomyoma of the appendix.
Primary leiomyoma and leiomyosarcoma of the appendix are extremely rare, and most often the diagnosis is histopathologic. We have reported the largest leiomyoma of the appendix known to date.
Adult↗
Argyrophil, non-argentaffin carcinoids of the appendix vermiformis. Immunohistochemical and ultrastructural studies.
Five argyrophil, non-argentaffin classical carcinoids of the appendix were found in 19 appendiceal classical carcinoids and were investigated histochemically, immunohistochemically and ultrastructurally. All tumors consisted entirely of argyrophil cells. Three of the five carcinoids were composed almost totally of peptide YY cells and were negative for serotonin. One of them consisted of peptide YY cells (60%), somatostatin cells (40%), and a few cells with glucagon-like immunoreactivity (GLI). The remaining one without peptides was homogeneously immunoreactive for serotonin alone. Ultrastructurally, each of the four peptide-positive carcinoids was composed of one kind of endocrine cell type with round secretory granules. Average diameter of granules were 150, 160, 190, and 210 nm, respectively. The non-argentaffin, serotonin-positive carcinoid showed predominant round secretory granules and a few irregular ones, both being 150 nm in largest diameter. It is suggested that the argyrophil, non-argentaffin carcinoids of the appendix are subdivided into two groups; carcinoids composed mainly of peptide (especially, peptide YY)-positive cells with round granules of D1 and/or L cell type and those of serotonin-positive cells with pleomorphic granules of ECn cell type.
Adolescent↗
Primary adenocarcinoma of the vermiform appendix associated with transitional cell carcinoma of the bladder.
A case of primary adenocarcinoma of the vermiform appendix coexisting with transitional cell carcinoma (TCC) of the bladder is presented. The patient was a 74-year-old male who underwent radical cystectomy with continent urinary diversion using the Florida pouch. Two different cancers were found, TCC of the bladder and mucinous adenocarcinoma of the appendix. To our knowledge, this is the only such case reported in the medical literature.
Adenocarcinoma, Mucinous↗
Adenocarcinoma of the appendix in older patients.
Acute inflammation of the appendix secondary to luminal obstruction is the chief reason for appendectomy. The rare association of a malignant neoplastic process with the inflammatory process is usually an unexpected finding and is often not diagnosed until the histologic study has been completed. Two patients with adenocarcinoma of the appendix are presented. They exemplify the diverse situations of intraoperative recognition with immediate definitive treatment, or surgical management after appendectomy alone. A review of the literature confirms the rarity of appendiceal adenocarcinoma in older patients. In this report, the pathophysiology of appendiceal carcinoma and guidelines for therapy are outlined. Emphasis is placed on the possible occurrence of a malignant appendiceal lesion in the elderly patient with acute appendicitis.
Adenocarcinoma↗
Adenocarcinoma of the vermiform appendix. A population study.
We report seven cases of adenocarcinoma of the vermiform appendix occurring in Iceland during 1974-1989. The patients ranged in age from 25-83 years, mean age 55.1 years. There were five males and two females. Five had mucinous adenocarcinoma, two had adenocarcinoma. Four patients presented with symptoms and signs of acute appendicitis and all had surgically resectable disease. Three of these patients were alive with no evidence of disease four months, two years and 15 years after presentation; one death of disease occurred seven years after ileocecal resection. In three cases, the clinical presentation was that of metastatic adenocarcinoma of unknown origin. Of these patients two were diagnosed at autopsy and one after appendectomy for perforated appendicitis. Survival in this group was six weeks, three months and twelve months, respectively. In none of our patients was the diagnosis made preoperatively and no tumors were found in appendices removed incidental to other intra-abdominal operations. The incidence of adenocarcinoma of the vermiform appendix in Iceland during 1974-1989 was approximately 0.2 cases/100.000/year.
Adenocarcinoma↗
The appendix of the ventricle of the larynx.
A review of 100 consecutive laryngograms showed visualization of the appendix of the laryngeal ventricle in 40% of cases. This high incidence of visulization is related to thorough anesthesia, repeated performance of phonation and the reverse "E" maneuver as well as awareness of the anatomical structure. The appendix of the laryngeal ventricle courses superiorly between the laryngeal vestibule and the thyroid cartilage which differentiates this normal structure from ulcerations and fistulous tracts of laryngeal tumors.
Anesthesia, Local↗