Bladder metastases of appendiceal mucinous adenocarcinoma: a case presentation.
BACKGROUND
Appendiceal adenocarcinoma is rare with a frequency of 0.08% of all surgically removed appendices. Few cases of appendiceal carcinoma infiltrating the bladder wall for spatial contiguity have been documented.


METHODS
A case is reported of a 45-years old woman with mucinous cystadenocarcinoma of the appendix with bladder metastasis. Although ultrasonography and voided urinary cytology were negative, abdomen computed tomography (CT) scan and cystoscopy and subsequent pathological examination revealed a mass exclusively located in the anterior wall of the bladder. Histopathology of the transurethral bladder resection revealed a bladder adenocarcinoma [6 cm (at the maximum diameter) x 2,5 cm; approximate weight: 10 gr] with focal mucinous aspects penetrating the muscle and perivisceral fat. Laparotomy evidenced the presence of a solid mass of the appendix (2,5 cm x 3 cm x 2 cm) extending to the loco-regional lymph nodes. Appendectomy and right hemicolectomy, linfoadenectomy and partial cystectomy were performed. The subsequent pathological examination revealed a mucinous cystadenocarcinoma of the appendix with metastatic cells colonising the anterior bladder wall and several colic lymph nodes.


CONCLUSIONS
The rarity of the appendiceal carcinoma invading the urinary bladder and its usual involvement of nearest organs and the posterior bladder wall, led us to describe this case which demonstrates the ability of the appendiceal cancer to metastasize different regions of urinary bladder.
Taverna
Gianluigi
G
Department of Urology, Via Manzoni 56 - 20089 Rozzano, Milan, Italy. gianluigi.taverna@humanitas.it
Corinti
Matteo
M
Colombo
Piergiuseppe
P
Grizzi
Fabio
F
Severo
Mauro
M
Piccinelli
Alessando
A
Giusti
Guido
G
Benetti
Alessio
A
Zucali
Paolo A
PA
Graziotti
Pierpaolo
P
D001063:Appendiceal Neoplasms / Q000473:pathology*; D018282:Cystadenocarcinoma, Mucinous / Q000473:pathology / Q000556:secondary*; D005260:Female; D006801:Humans; D008875:Middle Aged; D001749:Urinary Bladder Neoplasms / Q000556:secondary*