Mucinous adenocarcinoma diagnosed after appendectomy under general orotracheal anesthesia

Abstract

Mucinous adenocarcinoma of the appendix is an extremely rare entity. We present the case of a male patient with a history of diabetes mellitus with medical treatment and being an inveterate smoker. He presented to the emergency department complaining of an intense epigastric pain of two-day progress. He stated not having relief at rest or when taking medications. The pain radiated to the right iliac fossa and was accompanied by nausea. No other symptom was reported. The physical examination showed a diffuse pain on superficial and deep palpation of the abdomen, positive tenderness at the McBurney's point and a pulse of 110 bpm. An acute appendicitis in the elderly was diagnosed and surgical treatment was ordered. Rapid-sequence general orotracheal anesthesia was administered taking into account the diagnosis and the fact that these patients have onco-proliferative processes associated with age and prolonged surgical treatment, occasionally associated with great tumor resections. Appendectomy was performed and swelling of the distal third was observed, as well as accumulation of inner mucoid secretion. Histopathologic study was carried out which reported a mucinous adenocarcinoma. The patient did not develop any complications and was discharged four days after surgery. Nowadays he is asymptomatic and has an oncological follow-up.