Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2024; 12(8): 1461-1466
Published online Mar 16, 2024. doi: 10.12998/wjcc.v12.i8.1461
Appendiceal intussusception complicated by adenocarcinoma of the cecum: A case report
Yu Long, Yi-Ning Xiang, Fei Huang, Lei Xu, Xiao-Yun Li, Yun-Huan Zhen
Yu Long, Fei Huang, Xiao-Yun Li, Yun-Huan Zhen, Department of Colorectal Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guzihou Province, China
Yu Long, Lei Xu, Department of Colorectal Surgery, Guizhou Medical University, Guiyang 550001, Guizhou Province, China
Yi-Ning Xiang, Department of Pathology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guizhou Province, China
Author contributions: Long Y and Xiang YN performed image acquisition and completed the manuscript; All authors contributed to this paper and approved the submitted version.
Supported by the National Natural Science Foundation of China, No. 82060440.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that the study was conducted without any business or financial relationships that could be interpreted as potential conflicts of interest.
CARE Checklist (2016) statement: The authors read the CARE Checklist (2016) and prepared and revised the manuscript based on the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yun-Huan Zhen, PhD, Chief Physician, Department of Colorectal Surgery, The Affiliated Hospital of Guizhou Medical University, No. 16 Beijing Road, Yunyan District, Guiyang 550001, Guizhou Province, China. yunhuanzhen72@163.com
Received: November 19, 2023
Peer-review started: November 19, 2023
First decision: December 27, 2023
Revised: January 6, 2024
Accepted: February 18, 2024
Article in press: February 18, 2024
Published online: March 16, 2024
Processing time: 110 Days and 17.1 Hours
Abstract
BACKGROUND

Appendiceal intussusception is a pathological condition in which the appendix is inverted into the cecum, which may cause symptoms that resemble those of other gastrointestinal disorders and may induce intestinal obstruction. The rarity of this case presentation is the co-occurrence of appendiceal intussusception and cecal adenocarcinoma, a combination that to our knowledge has not previously been reported in the medical literature. This case provides new insights into the complexities of diagnosing and managing overlapping pathologies.

CASE SUMMARY

A 25-year-old woman presented with persistent periumbilical pain and bloody stools. An initial biopsy showed cecal cancer; however, subsequent colonoscopy and computed tomography findings raised the suspicion of appendiceal intussusception, which was later confirmed postoperatively. This unique case was characterized by a combination of intussusception and adenocarcinoma of the cecum. The intervention included a laparoscopic right hemicolectomy, which led to the histopathological diagnosis of mucinous adenocarcinoma with appendiceal intussusception. The patient recovered well postoperatively and was advised to initiate adjuvant chemotherapy. This case highlights not only the importance of considering appendiceal intussusception in the differential diagnosis, but also the possibility of appendicitis and the atypical presentation of neoplastic lesions.

CONCLUSIONS

Physicians should consider the possibility of appendiceal intussusception in cases of atypical appendicitis, particularly when associated with neoplastic presentation.

Keywords: Appendiceal intussusception; Appendicitis; Cecal cancer; Target signs; Misdiagnosis; Case report

Core tip: This report presents a unique case of appendiceal intussusception associated with cecal adenocarcinoma, which has rarely been reported in medical literature. This case highlights the diagnostic challenges posed by unconventional polyps and the complexity of the radiological findings in which malignancies and signs of intussusception coexist. This report emphasizes the need for thorough clinical and radiological evaluation and illustrates the potential of integrating various diagnostic tools to achieve accuracy. In addition, cecal tumors may extend into the appendix, complicating the presentation of standard appendiceal intussusception and requiring careful review of preoperative imaging to guide surgical intervention and subsequent treatment strategies.