M Younus, Tariq Nawaz, Asif Zafar Malik.
Primary Adenocarcinoma of the Vermiform Appendix.
Pak J Surg Jan ;18(1):41-2.

A 60 years old woman presented in July 1999 with the complaints of episodic pain in right iliac fossa, anorexia and weight loss for 2 months. Previously she had been treated conservatively for appendicular mass but without resolution. Abdominal examination revealed a firm to hard mobile mass in right iliac fossa. She was subjected to investigations with the suspicion of carcinoma of caecum. An ileocaecal mass was visualized on ultrasonography whereas barium enema examination was essentially normal. At exploration, a hard indurated mass measuring 6 x 3 x 2 cm was found involving the base of the appendix and caecum: terminal ileum was stuck to the mass. Appendix itself was acutely inflamed. Mesenteric lymph nodes were not enlarged and palpation of liver was unremarkable. A right hemicolectomy was performed and bowel continuity restored by ileo-transverse colostomy. The patient made an uneventful recovery. Histological examination of the specimen disclosed a well-differentiated adenocarcinoma of appendix, stage Duke C. The patient remained asymptomatic on follow-up examinations.

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