Acute Appendicitis Caused by Metastases from Squamous Cell Carcinoma of the Lung: A Case Report

• Published in: Nippon Shokaki Geka Gakkai zasshi Vol. 40; no. 4; pp. 473 - 477
• Main Authors: Tajima, Yosuke, Sakai, Yasuo, Yajima, Kazuhito, Musha, Nobuyuki, Tsubono, Toshihiro, Ogawa, Hiroshi, Suzuki, Susumu, Ishihara, Noriko
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 2007
• Subjects: appendicitis; appendix; lung cancer
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.40.473

We report a case of acute appendicitis resulting from metastatic squamous cell carcinoma of the lung. A 71-year-old man with pain in the lower right abdomen, and a medical history including lobectomy of the right lung for squamous cell carcinoma 12 months earlier had a final TNM stage of the original lung cancer of T4N2 M0. Physical examination showed severe tenderness and a positive Blumberg sign in the right lower abdominal quadrant. The white blood cell count had markedly increased to 22, 000/mm3 and serum C-reactive protein to 9.9mg/dl. Abdomino-pelvic computed tomography showed a mass in the appendix in the right lower abdominal cavity. Acute appendicitis was tentatively diagnosed, necessitating emergency surgery. At laparotomy, the appendix was found to be perforated and to contain dirty fluid. It was also adhering to the ileum through the upper part, necessitating appendectomy and partial resection of the ileum. Pathological examination showed a metastatic, poorly differentiated squamous cell carcinoma-a finding compatible with the history of lung carcinoma resected 12 months earlier in this patient.