Appendiceal goblet cell adenocarcinoma with peritoneal recurrence 9 years after surgery

阑尾杯状细胞腺癌术后9年出现腹膜复发

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Abstract

Goblet cell adenocarcinoma is extremely rare tumor in which the same cells have both exocrine and neuroendocrine properties. It is considered to be more aggressive than conventional carcinoids and more likely to cause metastasis. We report a case of goblet cell adenocarcinoma that developed late peritoneal recurrence, and we review pertinent literature. A 63-year-old male underwent appendectomy for acute appendicitis. Histopathological findings of appendectomy specimen showed mixed adenoneuroendocrine carcinoma, and positive resection margin. He also underwent laparoscopic ileocecal resection and apical lymph node dissection. After 9 years, he presented with ileus and abdominal CT examination indicated possible peritoneal dissemination. Laparoscopic observation revealed disseminated nodules throughout the entire abdominal cavity, and the patient underwent resection of the omental nodule and gastrointestinal bypass surgery. Previous appendectomy specimens showed goblet cell adenocarcinoma (GCA) according to the 5th edition of the WHO classification. Omental specimens confirmed the histopathological findings, and we diagnosed peritoneal recurrence of appendiceal goblet cell adenocarcinoma. Goblet cell adenocarcinoma may develop and cause late recurrence, and long-term follow-up may be required.

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