Metastatic gastric signet-ring cell carcinoma: A rare cause of acute appendicitis
Candaş Erçetin1, Ahmet Cem Dural2, Yaşar Özdenkaya3, Özlem Dural4, Huriye Gözde Muhafız Dada5, Gülçin Yeğen6, Yersu Kapran6, Yeşim Erbil7
1Clinic of General Surgery, Bağcılar Training and Research Hospital, İstanbul, Turkey
2Clinic of General Surgery, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
3Department of General Surgery, Medipol University School of Medicine, İstanbul, Turkey
4Department of Gynecology and Obstetrics, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
5Clinic of Pathology, Iğdır Public Hospital, Iğdır, Turkey
6Department of Pathology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
7Department of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
Abstract
We report a 32-year-old patient who underwent laparoscopy with classical symptoms and signs of acute appendicitis. An inflamed, edematous and non-perforated appendix, also a large amount gelatinous ascites, omental and peritoneal implants were seen. Appendectomy was performed and multiple biopsies were taken from omentum and peritoneum for definitive diagnosis. Histopathologic diagnosis was a metastatic gastric signet-ring cell carcinoma (GSRCC) involving appendix and other specimens. A flat lesion involving corpus to antrum was diagnosed by gastroscopy and GSRCC was verified histopathologically in a tertiary centre and the case evaluated as stage IV gastric carcinoma. This case with no sign of gastric cancer was presented as an acute appendicitis. Metastatic carcinoma to the appendix, causing acute appendicitis is extremely rare in clinical practice and usually associated with high morbidity and mortality.
Keywords: Acute appendicitis, gastric signet-ring cell carcinoma, metastasis
The patient was informed about all surgical and invasive procedures before surgery and during follow up. She was also expected to sign a form of approval.
Externally peer-reviewed.
Concept - C.E., A.C.D., Y.Ö., Ö.D., H.G.M.D., G.Y., Y.K., Y.E.; Design - C.E., A.C.D., Y.Ö., Ö.D., H.G.M.D., G.Y., Y.K., Y.E.; Supervision - C.E., A.C.D., Y.Ö., Ö.D., H.G.M.D., G.Y., Y.K., Y.E.; Funding - C.E., Y.Ö., H.G.M.D., G.Y., Y.K.; Materials - C.E., Y.Ö., H.G.M.D., G.Y., Y.K.; Data Collection and/or Processing - C.E., A.C.D., Ö.D.; Analysis and/or Interpretation - C.E., Ö.D., H.G.M.D., Y.K., Y.E.; Literature Review - C.E., A.C.D., G.Y., Y.E.; Writer - C.E., A.C.D.; Critical Review - C.E., Y.Ö., Ö.D., Y.K., Y.E.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.