Metastasis to the appendix from gastric cancer detected incidentally on colonoscopy

Abstract

A 59-year-old man complaining of anal pain was referred to our division for investigation. His medical history included a total gastrectomy for advanced poorly differentiated gastric adenocarcinoma, which had penetrated the serosa without invasion of adjacent structures or peritoneal dissemination. Colonoscopy revealed that the appendiceal orifice was generally elevated, as if pushed up by a solid appendiceal mass (Figure [1]). In addition, coarse, reddish mucosa was detected at the appendiceal orifice (Figure [2]). Histological examination of the biopsy specimens taken from the mucosa at the appendiceal orifice during colonoscopy revealed poorly differentiated adenocarcinoma, consistent with metastasis from the gastric carcinoma that had been surgically resected 1 year previously. Unfortunately, the patient died 1 year after receiving systemic chemotherapy.