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Medical Science Monitor Basic Research


Missed Gastric Cancer Metastasis to the Appendix: Case Report and Literature Review

Rare disease

Daeya Alhadid, Abdullah AlShammari, Hadeel Almana, Mohammad Aburahmah

Saudi Arabia College of Medicine, Alfaisal University, Riyadh, Saudi Arabia

Am J Case Rep 2020; 21:e920010

DOI: 10.12659/AJCR.920010

Available online: 2020-01-05

Published: 2020-01-05


BACKGROUND: Gastric cancer metastasis to the appendix is a rare condition that might present with symptoms of acute appendicitis or remain asymptomatic and be diagnosed incidentally. This report summaries 6 previously reported cases in addition to the presented case.
CASE REPORT: We report a 54-years-old female patient who presented with gastric cancer metastasis to the appendix that was found incidentally in the second surgery when she underwent bowel resection due to bowel entrapment in internal hernia, a complication of her primary gastric cancer surgical intervention. Six case-reports on gastric cancer metastasis to the appendix were reviewed. The metastasis was symptomatic in 4 cases, and solitary in 3 cases. The diagnosis was delayed in 4 cases as there was no evidence of metastasis at the diagnosis of the primary tumor; appendectomy was performed in all cases. The prognosis of the cases varied considerably.
CONCLUSIONS: We question the real incidence of appendiceal metastasis in gastric cancer, and the benefit-risk ratio of appendectomy in every gastrectomy. Guidelines on management of similar cases is also needed.

Keywords: Abdominal Neoplasms, Appendectomy, Neoplasm Metastasis