Hakim S, Amin M, Cappell MS. Limited, local, extracolonic spread of mucinous appendiceal adenocarcinoma after perforation with formation of a malignant appendix-to-sigmoid fistula: Case report and literature review. World J Gastroenterol 2016; 22(38): 8624-8630 [PMID: 27784975 DOI: 10.3748/wjg.v22.i38.8624]
Corresponding Author of This Article
Mitchell S Cappell, MD, PhD, Chief, Division of Gastroenterology and Hepatology, Department of Internal Medicine, William Beaumont Hospital, MOB #602, 3535 West Thirteen Mile Road, Royal Oak, MI 48073, United States. mscappell@yahoo.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Oct 14, 2016; 22(38): 8624-8630 Published online Oct 14, 2016. doi: 10.3748/wjg.v22.i38.8624
Limited, local, extracolonic spread of mucinous appendiceal adenocarcinoma after perforation with formation of a malignant appendix-to-sigmoid fistula: Case report and literature review
Seifeldin Hakim, Mitual Amin, Mitchell S Cappell
Seifeldin Hakim, Mitchell S Cappell, Division of Gastroenterology and Hepatology, Department of Internal Medicine, William Beaumont Hospital, Royal Oak, MI 48073, United States
Mitual Amin, Department of Pathology, William Beaumont Hospital, Royal Oak, MI 48073, United States
Mitual Amin, Mitchell S Cappell, Oakland University William Beaumont School of Medicine, Royal Oak, MI 48073, United States
Author contributions: All authors contributed to the manuscript; Hakim S and Cappell MS are equal primary authors.
Institutional review board statement: Case report exempted/approved 6/16/16 by William Beaumont Hospital IRB.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: None for all authors. This paper does not discuss any confidential pharmaceutical industry data reviewed by Dr. Cappell as a consultant for the United States Food and Drug Administration (FDA) Advisory Committee on Gastrointestinal Drugs. Dr. Cappell is a member of the speaker’s bureau for AstraZeneca and Daiichi Sankyo, co-marketers of Movantik. This work does not discuss any drug manufactured or marketed by AstraZeneca or Daiichi Sankyo.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mitchell S Cappell, MD, PhD, Chief, Division of Gastroenterology and Hepatology, Department of Internal Medicine, William Beaumont Hospital, MOB #602, 3535 West Thirteen Mile Road, Royal Oak, MI 48073, United States. mscappell@yahoo.com
Telephone: +1-248-5511227 Fax: +1-248-5517581
Received: July 11, 2016 Peer-review started: July 13, 2016 First decision: August 19, 2016 Revised: August 31, 2016 Accepted: September 12, 2016 Article in press: September 12, 2016 Published online: October 14, 2016 Processing time: 93 Days and 9.5 Hours
Core Tip
Core tip: A patient with mucinous appendiceal adenocarcinoma had appendiceal perforation that was locally contained by a malignant appendix-to-sigmoid fistula. The patient presented with right lower quadrant pain and tenderness and constipation. Abdomino-pelvic computed tomography and magnetic resonance imaging revealed a bulky peri-appendiceal mass containing an appendix-to-sigmoid-fistula. Pathologic analysis after debulking surgery revealed a locally extensive cancer involving appendix, sigmoid, and cecum and extending up to adjacent viscera with clear surgical margins and benign lymph nodes. The patient remained free of local recurrence/metastases during 1 year of follow-up despite not receiving chemotherapy/radiotherapy. This apparently favorable outcome is due to this cancer’s nonaggressive biology, and the fistula which likely largely contained cancer cell spillage within the colon and prevented free cancer cell spillage.
