Appendiceal Signet Ring Cell Carcinoma Presenting As Acute Appendicitis: A Case Report

Abstract

Appendiceal signet ring cell carcinoma is an exceedingly rare neoplasm which makes up only 4% of carcinomas of the appendix. It is a rare cause of abdominal pain which can mimic acute appendicitis. This case reports a 77-year-old female who presented to the emergency room with a complaint of right lower quadrant abdominal pain. After exploratory laparoscopy and histopathological studies, the patient was found to have peritoneal carcinomatosis and appendiceal signet ring cell carcinoma. This diagnosis unfortunately carries a relatively poor prognosis due to its aggressive nature. This study discusses the etiology, prevalence, clinical findings, and treatment of a rare cause of abdominal pain. This report sheds light on the importance of early detection and treatment of appendiceal signet ring cell carcinoma.

Keywords: appendiceal signet ring cell carcinoma; exploratory laparoscopy; gastrointestinal tumor; mimicker of acute appendicitis; rare neoplasm.

Figure 1. Abdominal T1-weighted axial view MRI without contrast (A) and T2-weighted axial view MRI with contrast (B).

Appendiceal and ileocecal thickening with abdominal and pelvic ascites, peritoneal thickening, and omental nodularity (arrows).

Figure 2. Abdominal T2-weighted coronal view image with contrast.

Image demonstrating appendiceal and peritoneal thickening and nodularity concerning perforated appendicitis with peritonitis versus appendix malignancy with carcinomatosis (arrows).

Figure 3. Intraoperative imaging of carcinomatosis of the abdominal wall.