Four Cases of Primary Appendiceal Cancer

Four cases of appendiceal cancer, which were encountered from 1991 to 1995 in the Department of Surgery, Tano General Hospital, were clinically investigated. The incidence of resection of one hundred eighty-nine colorectal cancers was 2.1% in the same period. The age range of the patients was from 36 to 56, and the mean age was 49 years. Three patients were prediagnosed as having acute appendicitis and one as having caecal cancer. The three former patients were treated by additional resection after appendectomy and the latter by right hemicolectomy. Microscopic examination of the appendixes showed one mucinous cystadenocarcinoma, two moderately-differentiated adenocarcinomas and one poorly-differentiated adenocarcinoma. Three appendiceal cancers were recognized in two hundred seventy-seven patients who underwent appendectomy for acute appendicitis and the incidence was 1.1% in the same period. Preoperative diagnosis of early appendiceal cancer was difficult, and differential diagnosis for acute appendicitis was especially difficult. After clinical analysis, rare appendiceal cancer should be kept in mind when appendectomy is performed. If malignancy is suspected in resected appendix, careful microscopic examination should be done and if it is malignant, an additional operation for colorectal cancer should be performed.