title: Combination of CT imaging and endoscopy in diagnosis of appendicovesical fistula caused by appendiceal adenocarcinoma.
abstract: The appendiceal diseases, particularly appendicitis, are the most common disorders in the digestive system localized at the right lower quadrant area. However, appendiceal carcinoma with vesico-appendiceal fistula is a rare clinical phenomenon. Lacking specific symptoms, appendiceal carcinomas with fistula formations are often misdiagnosed as acute appendicitis cases. The purpose of this study is to increase awareness of appendiceal neoplasms and appendicovesical fistulas. We reported our experiences in three complex cases related to digestive and urological systems, and reviewed the literature on diagnosis with various X-ray imaging techniques for this lesion. In this report, the first case failed to be diagnosed. The other two patients with appendicovesical fistulas secondary to appendiceal adenocarcinomas were successfully detected with computed tomography (CT) and cystoscopy. The patients recovered after right hemicolectomies and en bloc partial cystectomies and survived without tumor metastasis up to 7-year follow-up. In conclusion, a combined use of CT imaging and endoscopy techniques provides an accurate diagnostic alternative for appendicovesical fistula secondary to appendiceal adenocarcinoma.
authors: Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors: Wenying
authors: W
authors: Wang
authors: Center for Cancer Genomics, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
authors: Li
authors: L
authors: Wang
authors: Center for Cancer Genomics, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
authors: Jianfeng
authors: J
authors: Xu
authors: Department of Pathology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors: Shufang
authors: S
authors: Shi
authors: Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors: Ye
authors: Y
authors: Tian
authors: Institute for Regenerative Medicine, Wake Forest University, Winston-Salem, NC, USA.
authors: Yuanyuan
authors: Y
authors: Zhang
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D000368:Aged; D001063:Appendiceal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005402:Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Appendix adenocarcinoma; bladder; fistula