Abstract Acute appendicitis is a common surgical emergency, and antibiotic therapy is a safe and effective alternative to surgery for computed tomography (CT)-confirmed uncomplicated cases. Rarely, an underlying appendiceal tumor may present as acute or recurrent appendicitis. We report the case of a man in his early 60s with CT-confirmed uncomplicated appendicitis who initially recovered with antibiotics but re-presented 6 weeks later with recurrent symptoms. Laparoscopic appendectomy revealed a goblet cell adenocarcinoma (GCA, pT4a) of the appendix with lymphatic and perineural invasion. Staging imaging showed no synchronous colorectal lesions or metastases. Completion right hemicolectomy demonstrated no residual tumor or lymph node involvement (0/26; final stage pT4N0M0). Adjuvant chemotherapy was not administered, and at 1-year follow-up the patient remains disease-free. This case highlights that although appendiceal malignancy is rare in uncomplicated appendicitis, recurrence should prompt definitive surgical management and careful pathological evaluation, particularly in adults.
Nordström et al. (Wed,) studied this question.