RATIONALE

Appendiceal goblet cell adenocarcinoma (AGCA) synchronous with colorectal cancer (CRC) is extremely rare, with only a few cases reported in the literature. The oncogenic mechanisms, diagnosis, and treatment of the coexistence of AGCA and CRC face significant challenges. This case report describes a patient diagnosed with ascending colon adenocarcinoma and severe anemia. Pathological examination after radical right hemicolectomy revealed goblet cell adenocarcinoma in the appendix. The patient subsequently received postoperative chemotherapy, and the prognosis was favorable.

PATIENT CONCERNS

A 61-year-old female presented with abdominal pain and distension lasting over 6 months and was admitted to the hospital with a red blood cell count of 2.5 × 109/L and hemoglobin levels of 55.00 g/L.

DIAGNOSES

Abdominal computed tomography demonstrated thickening of the ascending colon, raising suspicion of a colon tumor, and no abnormality in the appendix. Colonoscopy confirmed the presence of a mass in the ascending colon, and the biopsy results suggested adenocarcinoma. The preoperative diagnosis was ascending colon adenocarcinoma with severe anemia.

INTERVENTIONS

After a multidisciplinary discussion, the patient underwent radical right hemicolectomy under general anesthesia.

OUTCOMES

Postoperative pathology revealed ascending colon adenocarcinoma and AGCA. The patient subsequently received postoperative chemotherapy, and the prognosis was favorable.

LESSONS

Synchronous AGCA with CRC are rare. The oncogenic mechanisms, diagnosis, and treatment of the coexistence of AGCA and CRC face significant challenges, and radical tumor resection combined with postoperative chemotherapy is an important treatment strategy. We contend that for patients with AGCA combined with ascending colon adenocarcinoma, radical right hemicolectomy is a reasonable approach, as it allows for the simultaneous radical resection of tumors in both locations.