levoleucovorin and Appendicitis

Primary appendiceal adenocarcinoma is a rare tumor, mucinous variety being common. This case is reported to highlight the unusual presentation and diagnostic difficulty of appendiceal adenocarcinoma.. Patient presented with acute appendicitis with ill-defined tender lump which responded to conservative management.. High index of suspicion should be kept in mind for elderly patients presenting with appendicular lump. Every effort should be made during elective appendectomy to remove stump in case of sloughed out appendix.

Topics: Abdominal Abscess; Adenocarcinoma; Age Factors; Antineoplastic Combined Chemotherapy Protocols; Appendectomy; Appendiceal Neoplasms; Appendicitis; Appendix; Carcinoembryonic Antigen; Chemotherapy, Adjuvant; Colectomy; Diagnosis, Differential; Elective Surgical Procedures; Female; Fluorouracil; Humans; Leucovorin; Lymph Node Excision; Lymph Nodes; Middle Aged; Neoplasm Staging; Organoplatinum Compounds; Rare Diseases; Tomography, X-Ray Computed; Ultrasonography

Signet ring carcinoma (SRC) of the appendix consists one of the most biologically virulent cancers. We present the case of a patient with primary SRC complicated by the development of acute inflammation of the appendix.. A 78-year-old man was admitted due to a 5-day history of increasing colicky abdominal pain and vomiting. Clinical examination revealed a firm, tender mass in the right ileac fossa. Laparotomy confirmed a tumor mass which appeared to originate from the appendix. The affected part of the bowel was resected and a right hemicolectomy with an end-to-side ileotransverse anastomosis was performed. The appendix was notably thickened with an ulcerated wall containing sinus tracts, chronic inflammation, and scarring. Moreover, a focus of SRC was detected.. Appendiceal SRC is a rare entity, which may sometimes be confused with other pathologies providing difficulties in differential diagnosis, having an impact on therapeutic decisions and affecting prognosis.

Topics: Abdominal Pain; Aged; Antimetabolites, Antineoplastic; Antineoplastic Agents; Appendiceal Neoplasms; Appendicitis; Carcinoma, Signet Ring Cell; Chemotherapy, Adjuvant; Diagnosis, Differential; Drug Therapy, Combination; Fluorouracil; Humans; Laparotomy; Leucovorin; Male; Organoplatinum Compounds; Oxaliplatin; Vitamin B Complex; Vomiting

Topics: Adenocarcinoma; Antineoplastic Combined Chemotherapy Protocols; Appendicitis; Colectomy; Colonoscopy; Colorectal Neoplasms; Combined Modality Therapy; Female; Fluorouracil; Humans; Incidental Findings; Leucovorin; Middle Aged; Neoplasm Metastasis; Neoplasm Staging; Organoplatinum Compounds; Thoracic Surgery, Video-Assisted; Tomography, X-Ray Computed

We report here a 20-year-old man presenting with primary nasal NK/T-cell lymphoma which showed an aggressive clinical course spreading to the spleen and skin despite various treatments. Eight months after high dose chemotherapy followed by autologous peripheral blood stem cell transplantation, acute appendicitis with perforation occurred and the patient underwent appendectomy. The histopathological diagnosis was NK/T-cell lymphoma of the appendix. Lymphoma of the appendix is extremely rare and the majority of appendiceal lymphomas are of B-cell origin. This is the first report of involvement of appendix by nasal NK/T-cell lymphoma.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Appendectomy; Appendiceal Neoplasms; Appendicitis; Bleomycin; Cisplatin; Combined Modality Therapy; Cyclophosphamide; Cytarabine; Doxorubicin; Epstein-Barr Virus Infections; Etoposide; Humans; Intestinal Perforation; Killer Cells, Natural; Leucovorin; Lymphoma, T-Cell; Male; Methotrexate; Methylprednisolone; Nitrosourea Compounds; Nose Neoplasms; Prednisone; Skin Neoplasms; Splenic Neoplasms; Tumor Virus Infections; Vincristine