Tumores apendiculares. A propósito de una apendicitis

Abstract

espanolObjetivo: Presentar un caso de un cistoadenocarcinoma mucinoso de apendice, diagnosticado a raiz de un cuadro clinico de apendicitis aguda. Metodo: Paciente varon de 82 anos valorado en Urgencias por cuadro de dolor abdominal. Con el diagnostico de abdomen agudo por sospecha de apendicitis aguda, se propone tratamiento quirurgico urgente identificandose una tumoracion apendicular de aspecto mucinoso. Resultado: Ante el diagnostico histologico de patologia tumoral se completa la cirugia con una hemicolectomia derecha laparoscopica. El seguimiento analitico y radiologico realizado, evidencia una elevacion progresiva del marcador tumoral Ca 19.9. En el control de los 30 meses se identifican signos de recidiva peritoneal valorando el inicio de tratamiento quimioterapico adyuvante, el cual es desestimado por la edad y la patologia de base del paciente. Conclusiones: La mayoria de tumores apendiculares son benignos y una apendicectomia simple es curativa. Determinados casos, en funcion de las caracteristicas histologicas, precisan completar la cirugia con una hemicolectomia derecha. EnglishObjective: To present an appendix adenocarcinoma case report mimicking acute appendicitis. Method: An 82 year old male was treated in the emergencies department presenting abdominal pain. He was diagnosed of acute abdomen due to a suspected case of acute appendicitis. An urgent surgical treatment was proposed and an appendiceal tumor with mucinous appearance was identified during the surgery. Result: The surgery was completed with a laparoscopic right hemicolectomy followed by the histological diagnosis of tumor pathology. The analytical and radiological examination evidenced a progressive elevation of the Ca 19.9 tumor marker. The 30-month post-intervention control revealed signs of peritoneal recurrence. The use of adjuvant chemotherapy was assessed but dismissed by the patient s age and underlying pathology. Conclusions: Most appendiceal tumors are benign and simple appendectomy is considered curative. Complete precision surgery with a right hemicolectomy is necessary in certain cases depending on the histological characteristics.