Autopsy and Case Reports
https://www.autopsyandcasereports.org/article/doi/10.4322/acr.2020.211
Autopsy and Case Reports
Clinical Case Report and Review

A rare cecal subepithelial tumor in a Crohn´s Disease patient

Joana Inês Alves da Silva; Cidalina Caetano; Anabela Maria Sousa da Rocha; Nuno Jorge Lamas; Paula Lago; Isabel Maria Teixeira de Carvalho Pedroto

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Abstract

ABSTRACT: Appendiceal tumors comprise a variety of histologic types, including appendiceal mucinous neoplasms, which can be grouped as premalignant lesions, tumors of uncertain malignant potential, and malignant lesions. The appendiceal mucinous neoplasms are characterized by mucinous epithelial proliferation with extracellular mucin and pushing tumor margins, commonly an incidental finding during operative exploration. We report the case of a low-grade appendiceal mucinous neoplasm presenting as a subepithelial lesion in Crohn´s Disease patient. The diagnosis was not straightforward, and only surgical resection allowed an accurate diagnosis. Although Inflammatory Bowel Disease is a risk factor for the development of colorectal neoplasms, the absolute risk for appendiceal tumors is uncertain. The frequency of progression to malignancy remains to be determined.

Keywords

Appendiceal tumors, Crohn´s Disease, Neoplasms, Cystic, Mucinous, and Serous

References

1 Gündoğar Ö, Kımıloğlu E, Komut N, et al. Evaluation of appendiceal mucinous neoplasms with a new classification system and literature review. Turk J Gastroenterol. 2018;29(5):533-42. http://dx.doi.org/10.5152/tjg.2018.17605. PMid:30260774.

2 Shaib WL, Assi R, Shamseddine A, et al. Appendiceal Mucinous Neoplasms: diagnosis and Management. Oncologist. 2017;22(9):1107-16. http://dx.doi.org/10.1634/theoncologist.2017-0081. PMid:28663356.

3 Carr NJ, Arends MJ, Deans GT, Sobin LH. Tumors of the Appendix. In: Hamilton SR, Aaltonen LA, editors. World Health Organization Classification of Tumors - Pathology and Genetics of Tumors of the Digestive System. Lyon: IARC; 2000. p. 93-102

4 Legué LM, Creemers G, De Hingh IHJT, Lemmens VEPP, Huysentruyt CJ. Pathology and its clinical relevance of mucinous appendiceal neoplasms and pseudomyxoma peritonei. Clin Colorectal Cancer. 2019;18(1):1-7. http://dx.doi.org/10.1016/j.clcc.2018.11.007. PMid:30611664.

5 Umetsu SE, Shafizadeh N, Kakar S. Grading and staging mucinous neoplasms of the appendix: a case series and review of the literature. Hum Pathol. 2017;69:81-9. http://dx.doi.org/10.1016/j.humpath.2017.09.005. PMid:28970138.

6 Yoshimoto T, Nishi M, Yoshikawa K, et al. A case of low-grade appendiceal mucinous neoplasm with invagination resected laparoscopically. Int Cancer Conf J. 2017;6(3):109-13. http://dx.doi.org/10.1007/s13691-017-0285-y. PMid:31149482.

7 Orta L, Trindade AJ, Luo JHN, Harpaz N. Appendiceal mucinous cystadenoma is a neoplastic complication of IBD: case-control study of primary. Inflamm Bowel Dis. 2009;15(3):415-21. http://dx.doi.org/10.1002/ibd.20764. PMid:18989894.

8 Sasaki H, Ikeuchi H, Bando T, et al. Clinicopathological characteristics of cancer associated with Crohn ’ s disease. Surg Today. 2017;47(1):35-41. http://dx.doi.org/10.1007/s00595-016-1336-2. PMid:27094049.

9 Amin MB, Greene FL, Edge SB, et al. The Eighth Edition AJCC Cancer Staging Manual: continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin. 2017;67(2):93-9.

10 Padmanaban V, Morano WF, Gleeson E, et al. Incidentally discovered low-grade appendiceal mucinous neoplasm: a precursor to pseudomyxoma peritonei. Clin Case Rep. 2016;4(12):1112-6. http://dx.doi.org/10.1002/ccr3.694. PMid:27980743.

11 González-Moreno S, Sugarbaker PH. Right hemicolectomy does not confer a survival advantage in patients with mucinous carcinoma of the appendix and peritoneal seeding. Br J Surg. 2004;91(3):304-11. http://dx.doi.org/10.1002/bjs.4393. PMid:14991630.

12 Perry WB, Opelka FG, Smith D, et al. Discontinuous appendiceal involvement in ulcerative colitis: pathology and clinical correlation. J Gastrointest Surg. 1999;3(2):141-4. http://dx.doi.org/10.1016/S1091-255X(99)80023-7. PMid:10457336.

13 Kulkarni D, Pinto DJ. Coexistence of Crohn’s disease and neuroendocrine tumor of appendix: more than coincidence? Int J Clin Pract. 2005;59(7):852-3. http://dx.doi.org/10.1111/j.1742-1241.2005.00533.x. PMid:15963215.

14 West NE, Wise PE, Herline AJ, Muldoon RL, Chopp WV, Schwartz DA. Carcinoid tumors are 15 times more common in patients with Crohn’s disease. Inflamm Bowel Dis. 2007;13(9):1129-34. http://dx.doi.org/10.1002/ibd.20172. PMid:17538985.

15 Hernández Benabe S, Leeman R, Brady AC, Hirzel A, Langshaw AH. Low-Grade Appendiceal Mucinous Neoplasm in an Adolescent Patient With Untreated Crohnʼs Disease. ACG Case Rep J. 2020;7(3):e00338. http://dx.doi.org/10.14309/crj.0000000000000338. PMid:32337304.

16 Wong U, Darwin P. Case report appendiceal mucocele diagnosed in patients with inflammatory bowel disease using endoscopic ultrasound. Case Rep Med. 2012;2012:849892. http://dx.doi.org/10.1155/2012/849892. PMid:22811730.

17 Kuester D, Dalicho S, Mönkemüller K, et al. Synchronous multifocal colorectal carcinoma in a patient with delayed diagnosis of ulcerative pancolitis. Pathol Res Pract. 2008;204(12):905-10. http://dx.doi.org/10.1016/j.prp.2008.07.011. PMid:18842350.

18 Lakatos PL, Gyori G, Halasz J, et al. Mucocele of the appendix: an unusual cause of lower abdominal pain in a patient with ulcerative colitis. A case report and review of literature. World J Gastroenterol. 2005;11(3):457-9. http://dx.doi.org/10.3748/wjg.v11.i3.457. PMid:15637769.

19 Lyda MH, Noffsinger A, Belli J, Fischer J, Fenoglio-Preiser CM. Multifocal neoplasia involving the colon and appendix in ulcerative colitis: pathological and molecular features. Gastroenterology. 1998;115(6):1566-73. http://dx.doi.org/10.1016/S0016-5085(98)70037-X. PMid:9834286.
 


Submitted date:
06/15/2020

Accepted date:
07/27/2020

Publication date:
12/08/2020

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