Primary appendiceal adenocarcinoma presenting as advanced ovarian cancer: a case report

BackgroundAlthough Primary appendiceal malignancies are rare accounting for less than 1% of all gastrointestinal tumors, the incidence of ovarian metastasis in appendiceal adenocarcinoma is encountered in 16.7 to 37% of all ovarian malignancy. The diagnosis is usually made after an exploratory laparotomy. Most of these tumors present with nonspecific symptoms, such as abdominal pain, abdominal fullness and huge pelvic mass, mimicking advanced stage ovarian cancer.Case PresentationWe described two menopausal women who were referred to our institution under the diagnostic impression of advanced stage of primary ovarian cancer. However, both patients were eventually found to have primary appendiceal adenocarcinoma with ovarian metastasis at laparotomy. Initial symptoms, intraoperative finding, pathology finding, and postoperative clinical courses were documented.ConclusionsComparing with primary ovarian tumor, ovarian metastasis is relatively rare. The clinical presentation can be misleading and the differential diagnoses of primary appendiceal cancer should be considered when preoperative workup is planned.