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Japanese Journal of Clinical Oncology 33:413-415 (2003)
© 2003 Foundation for Promotion of Cancer Research

Complete Appendiceal Intussusception Induced by Primary Appendiceal Adenocarcinoma in Tubular Adenoma: a Case Report

Minoru Takahashi1, Toshio Sawada1, Takahiro Fukuda1, Taiki Furugori1 and Hiroyuki Kuwano2,+

1 Department of Surgery, Gunma Cancer Center Hospital, Ohta, Gunma and 2 First Department of Surgery, Gunma University School of Medicine, Maebashi, Japan

A case of complete intussusception induced by appendiceal carcinoma is reported. The patient was a 49-year-old man complaining of rectal bleeding. Barium enema and colonoscopy revealed a cecal polyp; it was interpreted as an inverted appendix with a tumor. Computed tomography showed an invaginated appendix into the cecal cavity. During surgery, the appendix was found to be inverted completely into the cecum; ileocecal resection with regional lymph node dissection was performed. Microscopic examination revealed well-differentiated adenocarcinoma in tubular adenoma. Diagnosis of intussusception with carcinoma of the appendix is often difficult because appendiceal carcinoma with intussusception of the appendix is a rare condition. Although this condition can be diagnosed by radiographic imaging or colonoscopy, computed tomography has also been useful. The clinical manifestation of appendiceal intussusception with primary appendiceal tumor resembles a large cecal polyp, but its treatment differs greatly. Failure to recognize this condition may result in unexpected complications such as consequent peritonitis in case of endoscopic removal.

+ For reprints and all correspondence: Minoru Takahashi, Department of Surgery, Gunma Cancer Center Hospital, 617–1, Takabayashi-nishi, Ota, Gunma 373-8550, Japan. E-mail: minoru{at}gunma-cc.jp


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