Is T3 appendiceal goblet cell adenocarcinoma still an oncological riddle for acute care surgeons? A case report

Submitted: May 30, 2023
Accepted: September 19, 2023
Published: October 3, 2023
Abstract Views: 243
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Appendectomy for acute appendicitis is one of the most commonly performed surgical procedures nowadays. Here we present the case of a 48-year-old man who was admitted to our emergency department with abdominal pain suggestive of acute appendicitis. Then, the patient underwent a laparoscopic appendectomy, and the histological examination of the surgical specimen revealed an unexpected occult neoplasm: goblet cell adenocarcinoma (GCA). After a multidisciplinary evaluation, a right colectomy was performed with good oncological and clinical outcomes at the 1-year follow-up evaluation. To date, either nonoperative strategies or surgical radicalization treatment have been proposed for this condition. Therefore, the choice of the proper therapeutic algorithm is still a challenge for surgeons. This case report is an addition to the existing literature to hold surgeons' attention when managing such cases: multidisciplinary evaluation and patient-targeted therapies are the key steps to achieving good oncological and surgical outcomes.

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Citations

Cervellin G, Mora R, Ticinesi A, et al. Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases. Ann Transl Med 2016;4:362–362. DOI: https://doi.org/10.21037/atm.2016.09.10
Tang LH, Shia J, Soslow RA, et al. Pathologic classification and clinical behavior of the spectrum of goblet cell carcinoid tumors of the appendix. Am J Surg Pathol 2008;32:1429–43. DOI: https://doi.org/10.1097/PAS.0b013e31817f1816
Taggart MW, Abraham SC, Overman MJ, et al. Goblet cell carcinoid tumor, mixed goblet cell carcinoid-adenocarcinoma, and adenocarcinoma of the appendix: Comparison of clinicopathologic features and prognosis. Arch Pathol Lab Med 2015;139:782–90. DOI: https://doi.org/10.5858/arpa.2013-0047-OA
McCusker ME, Coté TR, Clegg LX, Sobin LH. Primary malignant neoplasms of the appendix: A population-based study from the surveillance, epidemiology and end-results program, 1973-1998. Cancer 2002;94:3307–12. DOI: https://doi.org/10.1002/cncr.10589
Kowalsky SJ, Nassour I, AlMasri S, et al. Omission of right hemicolectomy may be safe for some appendiceal goblet cell adenocarcinomas: A survival analysis of the national cancer database. Ann Surg Oncol 2021;28:8916–25. DOI: https://doi.org/10.1245/s10434-021-10191-y
Andersson M, Andersson RE. The appendicitis inflammatory response score: a tool for the diagnosis of acute appendicitis that outperforms the Alvarado score. World J Surg. 2008;32:1843–9. DOI: https://doi.org/10.1007/s00268-008-9649-y
Di Saverio S, Podda M, De Simone B, et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J Emerg Surg 2020;15:27. DOI: https://doi.org/10.1186/s13017-020-00306-3
Gomes CA, Sartelli M, Di Saverio S, et al. Acute appendicitis: proposal of a new comprehensive grading system based on clinical, imaging and laparoscopic findings. World J Emerg Surg 2015;10:60. DOI: https://doi.org/10.1186/s13017-015-0053-2
Amin MB, Edge S, Greene F, et al. AJCC Cancer Staging Manual. Springer International Publishing; 2017. DOI: https://doi.org/10.1007/978-3-319-40618-3
Vons C, Barry C, Maitre S, et al. Amoxicillin plus clavulanic acid versus appendicectomy for treatment of acute uncomplicated appendicitis: an open-label, non-inferiority, randomised controlled trial. Lancet 2011;377:1573–9. DOI: https://doi.org/10.1016/S0140-6736(11)60410-8
Pape U-F, Perren A, Niederle B, et al. ENETS consensus guidelines for the management of patients with neuroendocrine neoplasms from the jejuno-ileum and the appendix including goblet cell carcinomas. Neuroendocrinology 2012;95:135–56. DOI: https://doi.org/10.1159/000335629
Fields AC, Lu P, Enzinger A, et al. Treatment patterns and outcomes in goblet cell carcinoid tumors of the appendix. J Surg Oncol 2019;120:1096–101. DOI: https://doi.org/10.1002/jso.25723
Wang G, Li Q, Chen W. Chemotherapy in the treatment of different histological types of appendiceal cancers: a SEER based study. BMC Cancer 2021;21:778. DOI: https://doi.org/10.1186/s12885-021-08502-3
Palmer K, Weerasuriya S, Chandrakumaran K, et al. Goblet cell adenocarcinoma of the appendix: A systematic review and incidence and survival of 1,225 cases from an English cancer registry. Front Oncol 2022;12:915028. DOI: https://doi.org/10.3389/fonc.2022.915028
Rossi RE, Luong T-V, Caplin ME, et al. Goblet Cell Appendiceal Tumors - Management Dilemmas and Long-Term Outcomes. Surg Oncol 2015;24:47–53. DOI: https://doi.org/10.1016/j.suronc.2015.01.001
Olsen IH, Holt N, Langer SW, et al. Goblet cell carcinoids: characteristics of a Danish cohort of 83 patients. PLoS One 2015;10:e0117627. DOI: https://doi.org/10.1371/journal.pone.0117627
Tsang ES, McConnell YJ, Schaeffer DF, et al. Outcomes of surgical and chemotherapeutic treatments of goblet cell carcinoid tumors of the appendix. Ann Surg Oncol 2018;25:2391–9. DOI: https://doi.org/10.1245/s10434-018-6560-0
Madsen AH, Ladekarl M, Villadsen GE, et al. Effects of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of goblet cell carcinoma: A prospective cohort study. Ann Surg Oncol 2018;25:422–30. DOI: https://doi.org/10.1245/s10434-017-6272-x
Wajekar AS, Solanki SL, Patil VP. Postoperative complications and critical care management after cytoreduction surgery and hyperthermic intraperitoneal chemotherapy: A systematic review of the literature. World J Crit Care Med 2022;11:375–86. DOI: https://doi.org/10.5492/wjccm.v11.i6.375

How to Cite

Bergna, A., Salvetti, F., Carando, S., Monti, M., & Segalini, E. (2023). Is T3 appendiceal goblet cell adenocarcinoma still an oncological riddle for acute care surgeons? A case report. Case Reports in Emergency Surgery and Trauma, 1(1). https://doi.org/10.4081/crest.2023.16