Primary appendiceal adenocarcinoma.

Primary appendiceal adenocarcinoma is rare, with fewer than 300 reported cases. This report reviews 23 cases of appendiceal adenocarcinoma at Butterworth Hospital from 1968 to 1985. Clinical presentation, operative findings, treatment, and length of survival were recorded. Common clinical presentations included acute appendicitis and progressive abdominal distention. This disease was frequently an incidental finding during unrelated elective surgery and was often associated with other primary malignancies. Surgical treatment included appendectomy, right hemicolectomy, and interval hemicolectomy after initial appendectomy. Improved survival was noted in patients who had localized and noninvasive disease. Prognosis was most closely related to tumor grade. No patient who had localized, well-differentiated tumor died from the disease or had evidence of tumor recurrence after surgical treatment. All patients with poorly differentiated tumors died from widespread carcinomatosis. Appendectomy appears to be sufficient treatment for well-differentiated, localized, mucus secreting adenocarcinomas of the appendix.