Location
Moultrie, GA
Start Date
7-5-2025 1:00 PM
End Date
7-5-2025 4:00 PM
Description
Introduction:
Goblet cell carcinoma (GCC) is a rare subtype of appendiceal neoplasm characterized by both glandular and neuroendocrine features. It accounts for less than 5% of appendiceal tumors, often presenting diagnostic and therapeutic challenges due to its aggressive behavior.
Case Presentation:
This case report discusses a 62-year-old female patient who presented with diffuse abdominal pain and distension. Imaging revealed a large bowel obstruction in the sigmoid colon, pneumatosis of the ascending colon, and pneumoperitoneum. Exploratory laparotomy was significant for large bowel obstruction at sigmoid colon, proximal transverse colon perforation with carcinomatosis involving small bowel, large bowel and ovary. A subtotal colectomy, omentectomy, ileostomy, and a right salpingo-oophorectomy was performed. Histopathological investigation identified GCC of the appendix and subsequent staging was pT4bpN2pM1b. Postoperative recovery was complicated by abdominal fascial dehiscence which healed with the assistance of an ovine biological matrix. Adjuvant chemotherapy was initiated thereafter.
Discussion:
As a complex cancer, GCC requires histopathological evaluation with certain markers including chromogranin A, synaptophysin, and mucin markers to differentiate it from other appendiceal tumors. With rapidly decreasing 5-year survival rate with advancing stage, management will include appendectomy and right hemicolectomy for localized disease, surgical debulking and intraperitoneal chemotherapy/HIPEC for peritoneal carcinomatosis, and systemic chemotherapy for metastatic disease.
Conclusion:
This case offers an understanding of the aggressive nature of this subtype of appendiceal cancer and the importance of histopathological evaluation and the need for a multidisciplinary approach to managing this rare malignancy. Early diagnosis and appropriate surgical management are important in optimizing the outcomes and survival for patients with GCC.
Embargo Period
6-3-2025
Included in
A Case Report: Goblet Cell Carcinoma of the Appendix
Moultrie, GA
Introduction:
Goblet cell carcinoma (GCC) is a rare subtype of appendiceal neoplasm characterized by both glandular and neuroendocrine features. It accounts for less than 5% of appendiceal tumors, often presenting diagnostic and therapeutic challenges due to its aggressive behavior.
Case Presentation:
This case report discusses a 62-year-old female patient who presented with diffuse abdominal pain and distension. Imaging revealed a large bowel obstruction in the sigmoid colon, pneumatosis of the ascending colon, and pneumoperitoneum. Exploratory laparotomy was significant for large bowel obstruction at sigmoid colon, proximal transverse colon perforation with carcinomatosis involving small bowel, large bowel and ovary. A subtotal colectomy, omentectomy, ileostomy, and a right salpingo-oophorectomy was performed. Histopathological investigation identified GCC of the appendix and subsequent staging was pT4bpN2pM1b. Postoperative recovery was complicated by abdominal fascial dehiscence which healed with the assistance of an ovine biological matrix. Adjuvant chemotherapy was initiated thereafter.
Discussion:
As a complex cancer, GCC requires histopathological evaluation with certain markers including chromogranin A, synaptophysin, and mucin markers to differentiate it from other appendiceal tumors. With rapidly decreasing 5-year survival rate with advancing stage, management will include appendectomy and right hemicolectomy for localized disease, surgical debulking and intraperitoneal chemotherapy/HIPEC for peritoneal carcinomatosis, and systemic chemotherapy for metastatic disease.
Conclusion:
This case offers an understanding of the aggressive nature of this subtype of appendiceal cancer and the importance of histopathological evaluation and the need for a multidisciplinary approach to managing this rare malignancy. Early diagnosis and appropriate surgical management are important in optimizing the outcomes and survival for patients with GCC.