title: Appendiceal mucinous cystadenocarcinoma with implantation metastasis to the incision scar and cutaneous fistula.
abstract: BACKGROUND
  Mucinous cystadenocarcinoma of the appendix with invasion of the anterior abdominal wall and cutaneous fistula development is a rare condition. To the best of the authors' knowledge, five such cases have been reported in the medical literature.
  
  
  RESULTS
  The patient was a 68-year-old man who presented with a mass growing through the incisional scar and a skin fistula with mucinous discharge 1 year after appendectomy via McBurney's incision. Carcinoembroyonic antigen and carbohydrate antigen 19-9 concentration was elevated. Abdominal computed tomography scan revealed a mass in the cecum with involvement of the abdominal wall. Right hemicolectomy with en bloc abdominal wall implant and skin fistula resection with clear margins was performed.
  
  
  CONCLUSIONS
  The patient received intraperitoneal intra- and postoperative chemotherapy. Gross examination of the specimen showed a mass emerging from the remnant stump of the appendix. The patient showed no relapse 1 year after surgery. Clinical, paraclinical features, and treatment options are discussed with review of the literature.
authors.affiliation: First Department of Surgery N. Anestiadi & Laboratory of Hepato-Pancreato-Biliary Surgery, Medical University N. Testemitsanu, National Center of Emergency Medicine, Kishinev, Moldova. mishin_igor@mail.ru
authors.forename: Igor
authors.initials: I
authors.lastname: Mishin
authors.forename: Gheorghe
authors.initials: G
authors.lastname: Ghidirim
authors.forename: Marin
authors.initials: M
authors.lastname: Vozian
mesh_terms: D034861:Abdominal Wall / Q000473:pathology / Q000601:surgery; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001062:Appendectomy / Q000009:adverse effects*; D001063:Appendiceal Neoplasms / Q000473:pathology* / Q000628:therapy; D001064:Appendicitis / Q000601:surgery; D002921:Cicatrix / Q000473:pathology; D017577:Cutaneous Fistula / Q000473:pathology* / Q000601:surgery; D018282:Cystadenocarcinoma, Mucinous / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008297:Male; D009078:Mucocele / Q000601:surgery; D009366:Neoplasm Seeding
chemical_list: D000970:Antineoplastic Agents