Endoscopically unobservable appendiceal adenoma treated using laparoscopically assisted surgery

Tomohiro Kurokawa; Yoshiaki Kanemoto; Yuki Azuma; Kentaro Yazawa; Giichiro Tsurita

doi:10.1016/j.ijscr.2021.105949

Endoscopically unobservable appendiceal adenoma treated using laparoscopically assisted surgery

Int J Surg Case Rep. 2021 Jun:83:105949. doi: 10.1016/j.ijscr.2021.105949. Epub 2021 Apr 30.

Authors

Tomohiro Kurokawa¹, Yoshiaki Kanemoto², Yuki Azuma², Kentaro Yazawa², Giichiro Tsurita²

Affiliations

¹ Department of Surgery, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Japan. Electronic address: kurokawa@ims.u-tokyo.ac.jp.
² Department of Surgery, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Japan.

Abstract

Introduction: Primary benign adenomas of the appendix occur rarely. According to appendectomy and autopsy reports, benign adenomas of the appendix are sporadically reported, accounting for ~0.02-0.08% cases.

Presentation of case: We report the case of a 58-year-old woman with a segmental polyp protruding into the appendiceal orifice. The polyp was spotted during lower gastrointestinal endoscopy; however, treatment was postponed at the patient's request. During a confirmatory lower gastrointestinal endoscopy for treatment, the polyp was no longer found protruding from the appendiceal orifice and had disappeared. An appendicectomy was performed for diagnostic and therapeutic purposes. Pathological examination showed a low-degree atypical tubular adenoma with no malignant findings.

Discussion: Despite the risk of perforation, surgical resection remains the gold standard for treating appendiceal adenoma. Resection can be performed endoscopically if the stem and base of the adenoma can be identified. In the present case, laparoscopy was a good indication from the safety standpoint, and it was radically curative. Furthermore, upon performing an appendectomy, the patient was informed of the risks of cancer-related complications or the need for additional resection.

Conclusion: This suggestive case proves that appendiceal tumors can disappear endoscopically depending on the timing of examination and treatment.

Keywords: Atypical tubular adenoma; Benign adenoma; Case report; Laparoscopically assisted appendectomy; Primary appendix.