Goblet cell adenocarcinoma of the appendix: A case report of three cases

Nami Kiyosawa; Makoto Koyama; Yusuke Miyagawa; Masato Kitazawa; Shigeo Tokumaru; Yuji Soejima

doi:10.1016/j.ijscr.2023.108229

Goblet cell adenocarcinoma of the appendix: A case report of three cases

Int J Surg Case Rep. 2023 May:106:108229. doi: 10.1016/j.ijscr.2023.108229. Epub 2023 Apr 18.

Authors

Nami Kiyosawa¹, Makoto Koyama², Yusuke Miyagawa¹, Masato Kitazawa¹, Shigeo Tokumaru¹, Yuji Soejima¹

Affiliations

¹ Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
² Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan. Electronic address: m_koyama@shinshu-u.ac.jp.

Abstract

Introduction and importance: Appendiceal goblet cell adenocarcinoma is in 0.3-0.9 % of appendectomy specimens. There is still controversy regarding whether surgery with dissection or additional resection is necessary for goblet cell adenocarcinoma and whether adjuvant chemotherapy is practical. We present three cases of goblet cell adenocarcinomas.

Case presentation: Case 1: A 30-year-old woman was diagnosed with appendicitis and underwent appendicectomy. Histopathological evaluation revealed a malignant neoplasm with goblet-like cells and tumour infiltration into the subserosa. The patient underwent laparoscopic ileocecal resection, and the main lymph nodes at the root of the feeding vessels were removed. Case 2: A 50-year-old man was diagnosed with appendicitis and underwent appendicectomy. Histopathological evaluation revealed a malignant neoplasm with goblet-like cells; malignant cells were found at the surgical resection margins. The patient underwent laparoscopic ileocolic resection. Case 3: A 60-year-old man undergoing treatment for malignant melanoma. He was diagnosed with appendicitis associated with an appendiceal tumour, and emergency laparoscopic caecal resection was performed and diagnosed as goblet cell adenocarcinoma. We decided to prioritize treatment for malignant melanoma, and the patient is under follow-up for goblet cell adenocarcinoma and no metastasis was detected.

Clinical discussion: We performed additional resection in two case of goblet cell adenocarcinoma. Diagnosing appendiceal goblet cell adenocarcinoma is difficult, and the prognosis of patients with positive lymph nodes is poor. Surgical treatment should be considered for the advanced stages of this disease.

Conclusion: Goblet cell adenocarcinoma, diagnosed after appendectomy, additional resection including lymph node dissection may provide a long-term prognosis.

Keywords: Appendiceal neoplasm; Goblet cell adenocarcinoma; Goblet cell carcinoid; Right hemicolectomy.