2 in 1: Which one to remove?

Mahno, Noor Ezmas and Ong, David and B, Mohd Nurshamizam and Mohd Nor, Azmi (2015) 2 in 1: Which one to remove? In: Coloproctology 2015 International Scientific Meeting, 12th-15th March 2015, Melaka. (Unpublished)

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Abstract

Synchronous primary appendiceal tumor in colorectal cancer is very rare. Unexpected appendicular neoplasm diagnose intraoperatively pose a management dilemma. Case Summary: This is a 68 years old gentleman with underlying diabetes, hypertension and history of stroke 3 years ago with right hemiplegia presented with per rectal bleeding for 2 weeks. Colonoscopy found clinically obstructing tumor at rectosigmoid junction and biopsy of the tumor came back as moderately differentiated adenocarcinoma. CT scan for staging showed no distant metastasis. After discussing option with family, we decided to proceed with surgery. Intraoperatively, we found a huge rectosigmoid tumor with multiple mucinous cysts around it. We also found a bulky appendix (1.5cm) with healthy base. We did appendicectomy, resected the rectosigmoid tumor with good oncologic margin and brought out the descending colon as stoma. He recovered and discharged well. Surprisingly, the rectosigmoid tumor was moderately differentiated adenocarcinoma (not otherwise specific) with good surgical margin and staging as pT2N0Mx. The appendix’s histology reported as mucinous adenocarcinoma with involved surgical margin and presence of metastatic tumor deposit on the pericolic fat and serosal layer of the rectosigmoid specimen. The appendiceal tumor staging was pT4Nx M1. The family was not keen for another surgery so we had a close follow-up for recurrence and oncology referral for chemoradiation therapy

Item Type:	Conference or Workshop Item (Poster)
Additional Information:	6610/58386
Uncontrolled Keywords:	appendiceal tumor, appendicular neoplasm
Subjects:	R Medicine > RD Surgery
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Surgery
Depositing User:	Dr Noor Ezmas Mahno
Date Deposited:	26 Sep 2017 15:11
Last Modified:	26 Sep 2017 15:11
URI:	http://irep.iium.edu.my/id/eprint/58386

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