Adenocarcinoma of the appendix in older patients.

Acute inflammation of the appendix secondary to luminal obstruction is the chief reason for appendectomy. The rare association of a malignant neoplastic process with the inflammatory process is usually an unexpected finding and is often not diagnosed until the histologic study has been completed. Two patients with adenocarcinoma of the appendix are presented. They exemplify the diverse situations of intraoperative recognition with immediate definitive treatment, or surgical management after appendectomy alone. A review of the literature confirms the rarity of appendiceal adenocarcinoma in older patients. In this report, the pathophysiology of appendiceal carcinoma and guidelines for therapy are outlined. Emphasis is placed on the possible occurrence of a malignant appendiceal lesion in the elderly patient with acute appendicitis.