Metastatic small cell lung cancer presenting as acute appendicitis: a case report

Author:

Connell Louis1ORCID,Ng Ziqin1,Tai Wei Zhong1,Allanson Ben1

Affiliation:

1. Acute Surgical Unit, Sir Charles Gairdner Hospital Perth , Western Australia , Australia

Abstract

AbstractWe present a case of extensive stage small cell lung cancer presenting as perforated appendicitis secondary to an appendiceal metastasis. This is a rare presentation with only six reported cases in the literature. Surgeons must be aware of unusual causes for perforated appendicitis as in our case the prognosis can be dire. A 60-year-old man presented with an acute abdomen and septic shock. Urgent laparotomy and a subtotal colectomy were performed. Further imaging suggested the malignancy was secondary to a primary lung cancer. Histopathology demonstrated a ruptured small cell neuroendocrine carcinoma in the appendix with thyroid transcription factor 1 positive immunohistochemistry. Unfortunately, the patient deteriorated due to respiratory compromise and was palliated day six postoperatively. Surgeons should consider a broad differential diagnosis for the cause of acute perforated appendicitis as this can rarely be due to a secondary metastatic deposit from a widespread malignant process.

Publisher

Oxford University Press (OUP)

Subject

Surgery

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3. The SCARE 2020 guideline: updating consensus surgical CAse REport (SCARE) guidelines;Agha;Int J Surg,2020

4. Current standards for clinical management of small cell lung cancer;Farago;Transl Lung Cancer Res,2018

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