Appendiceal intussusception complicated by adenocarcinoma of the cecum: A case report

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.