Appendiceal Mucinous Adenocarcinoma with

Concurrent Tuberculous Appendix: An Unusual Overlap

of Two Rare Diseases
Khei Jazzle Lim ,
1 Vlu Jean Zara ,
1 Manuel Roxas1

1The Medical City, Surgery, Pasig, Philippines.

Introduction Results
Primary tumors of the appendix are rare and present After surgery, the patient continued
with symptoms of acute appendicitis or a palpable antimycobacterial medication and no chemotherapy
right lower quadrant mass. The appendix is also an was given. At present, the patient has no
uncommon site of granulomatous tuberculosis recurrence. CT scan and colonoscopy done and
infection for gastrointestinal extra pulmonary disease. showed normal results.
This case report highlights an unusual overlap of the Figure #3 Histopathology
two diseases and a brief review of literature.

Materials/Methods:
A Case Report
A 52-year-old woman presented with right lower
quadrant pain and a palpable mass, and was
surgically managed with right hemicolectomy, right
en bloc salpingo-oophorectomy, and total
omentectomy. Medical treatment with standard
quadruple antimycobacterial regimen was also
initiated. Histopathologic report showed appendiceal
mucinous adenocarcinoma with concurrent
tuberculous appendix.

Figure #1
Conclusion
To the best of our knowledge, surgical tumor
Colonoscopy resection followed by antimycobacterial regimens is
Friable mass seen. Almost completely the preferred management for this case, an overlap
obstructing the cecal lumen of two rare diseases in the appendix. Moreover, it is
unknown if either pathology contributed to the
pathogenesis of the other. This controversy currently
remains unsolved and it is possible that the overlap
Figure #2 between the two pathologies was coincidental. The
Specimen question of causality remains to be answered.
Furthermore, the rarity of the disease and overlap
Right hemicolectomy makes this highly difficult to study. More research
with salpingo- into the pathogenesis and interplay between each
oophorectomy and total
omentectomy. A. Gross
pathology is needed.
morphology of the mass
shows a 5 x 5 cm solid
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