BMC Surgery (Nov 2019)

Complete appendiceal inversion with local high-grade intraepithelial neoplasia in an adult female: a case report

  • Xinlu Liu,
  • Ge Liu,
  • Yanfeng Liu,
  • Hongsheng Zhou,
  • Liyu Yu,
  • Yun Xu,
  • Xue Song,
  • Jing Zhang

DOI
https://doi.org/10.1186/s12893-019-0632-3
Journal volume & issue
Vol. 19, no. 1
pp. 1 – 4

Abstract

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Abstract Background Appendiceal inversion with neoplasia in adults is an extremely rare event with a reported incidence of < 0.01%. Preoperative diagnosis is very important for surgical treatment; however, it is very difficult to be exact. Case presentation The patient was a 60-year-old woman with complaints of intermittent abdominal pain. Computed tomography and colonoscopy revealed a cecal mass, which was diagnosed as a tubulovillous adenoma in the preoperative colonoscopic biopsy. At surgery, the appendix was found to be completely inverted into the cecum. The cecum was partially resected, and surgical pathology examination confirmed a tubulovillous adenoma of the appendix with local high-grade intraepithelial neoplasia. Conclusions Although preoperative diagnosis of appendiceal inversion with neoplasia may be often difficult due to its non-specific symptoms, clinicians should consider this disease entity when they encounter an intraluminal protruding cecal mass without visualization of the normal appendix on CT and colonoscopy.

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