[Primary adenocarcinoma of the appendix as differential diagnosis of advanced ovarian carcinoma]

Malignant tumours of the appendix are rare. They are usually carcinoid tumours that must be distinguished from extremely rare adenocarcinomas. Metastatic mucinous adenocarcinomas of the appendix are only reported as case histories. In clinical terms, the tumours usually manifest themselves as acute appendicitis, as ruptured appendicitis, as a tumour in the right lower abdominal quadrant or as a pelvic tumour, which are generally mistaken for an ovarian tumour with the same sonographic image. Advanced primary adenocarcinomas of the appendix with ovarian metastases cannot be distinguished intraoperatively from a FIGO III ovarian carcinoma. The pathologist makes the definitive diagnosis. These characteristics also apply to the case presented here. Surgical therapy of the isolated primary appendiceal carcinoma consists of a hemicolectomy--an appendectomy in favourable cases--and, in the case of a metastasised carcinoma, according to the guidelines for an advanced ovarian or colon carcinoma. The effect of chemotherapy is insufficiently documented.