A Case of Laparoscopic Cecectomy for Xanthogranulomatous Appendicitis

ISOKAWA Marina, SATO Aya, IMAIZUMI Ken, SATO Kentaro, KASAJIMA Hiroyuki, KUSHIBIKI Hanae, SHIMOYAMA Norihiko, NAKANISHI Kazuaki

doi:10.3919/jjsa.83.1948

<p>An 87-year-old woman was admitted due to right lateral abdominal pain. Initial computed tomography (CT) showed appendiceal enlargement with inflammation. Blood tests showed that her serum C-reactive protein levels were mildly elevated. All tumor markers were negative. Since her symptoms and inflammatory findings were trivial, a follow-up CT was performed. CT showed that the enlarged appendix was smaller. Furthermore, colonoscopy showed redness and swelling of the mucous membrane at the orifice of the appendix. The biopsy of the mass showed no signs of malignancy. A laparoscopic cecectomy was performed for a suspected benign tumor. Since no malignancy was noted in the intraoperative resection specimen, additional resection with lymph node dissection was not performed. The pathological diagnosis was xanthogranulomatous appendicitis. Xanthogranulomatous appendicitis is a rare disease that is challenging to distinguish from malignant tumors preoperatively. According to previous reports, an ileocolic resection or a right hemicolectomy with lymph node dissection may be performed for this disease. If a benign disease is suspected based on the patient's clinical course and multimodality examinations, organ-preserving surgery, such as an appendectomy or a cecectomy without lymph node dissection, may be performed.</p>

A Case of Laparoscopic Cecectomy for Xanthogranulomatous Appendicitis

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