Case Report
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World J Gastrointest Surg. Aug 27, 2010; 2(8): 265-269
Published online Aug 27, 2010. doi: 10.4240/wjgs.v2.i8.265
Peritoneal seeding from appendiceal carcinoma: A case report and review of the literature
Valentina R Bertuzzo, Federico Coccolini, Antonio D Pinna
Valentina R Bertuzzo, Federico Coccolini, Antonio D Pinna, Department of General, Emergency and Transplant Surgery, Sant'Orsola-Malpighi University Hospital, Via Massarenti 9, 40138 Bologna, Italy
Author contributions: Bertuzzo VR was responsible for the conception and design of the study, acquiring, analyzing and interpreting the data, drafting the manuscript and for critical revision; Coccolini F was responsible for analyzing and interpreting the data and for critical revision; Pinna AD was responsible for critical revision of the paper
Correspondence to: Valentina R Bertuzzo, MD, Department of General, Emergency and Transplant Surgery, Sant'Orsola-Malpighi University Hospital, Via Massarenti 9, 40138 Bologna, Italy. valentinabertuzzo@hotmail.com
Telephone: +39-051-6363597 Fax: + 39-051-6363719
Received: January 26, 2010
Revised: March 22, 2010
Accepted: March 29, 2010
Published online: August 27, 2010
Abstract

Non-carcinoid appendiceal malignancies are rare entities, representing less than 0.5% of all gastrointestinal malignancies. Because of their rarity and particular biological behavior, a substantial number of patients affected by these neoplasms do not receive appropriate surgical resection. In this report, we describe a rare case of primary signet-ring cell carcinoma of the appendix with peritoneal seeding which occurred in a 40-year old man admitted at the Emergency Surgery Department with the clinical suspicion of acute appendicitis. After a surgical debulking and right hemicolectomy, the patient had systemic chemotherapy according to FOLFOX protocol. After completion of the latter, the patient underwent cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy. This report offers a brief review of the literature and suggests an algorithm for the management of non-carcinoid appendiceal tumors with peritoneal dissemination.

Keywords: Appendiceal neoplasms, Signet-ring cell carcinoma, Peritoneal carcinomatosis, Hyperthermic intraperitoneal chemotherapy, Therapeutic algorithm