Mucinous adenocarcinoma of the appendix: case study with intraoperative approach

Abstract

Objective: To report the case of a patient who presented with adenocarcinoma of the appendix with an intraoperative diagnosis. Case details: A 66-year-old male patient was admitted to the emergency department of a hospital in the interior of São Paulo with abdominal pain in the right iliac fossa for 4 days, with a diagnostic hypothesis of acute appendicitis. In an intraoperative approach, a hypothesis of appendix neoplasia was raised. Therefore, a double-stapled right colectomy was performed. It was noted the presence of inflammatory fluid with adherence and a whitish oval-shaped mass in the appendix region. A detachment of the tumor was then performed in the region of the retroperitoneum, where no apparent invasion of noble structures was identified, but there was significant thickening in this region. Cattel's maneuver and resection of the right colon and terminal ileum were performed with double stapled laterolateral anastomosis of the beginning and transverse terminal ileum (near the angle) with manual reinforcement of the anastomosis. Final considerations: The appendix tumor is uncommon in medical practice and there is rarely an initial hypothesis of the same before surgical approach, therefore the importance of studies about it to enrich the literature and correct diagnoses.