title: Persistent Coughing as the First Symptom of Primary Mucinous Appendiceal Adenocarcinoma.
abstract: Primary appendiceal adenocarcinomas are extremely rare entities. Preoperative diagnosis is very difficult and is mainly based on computed tomography (CT) scan findings. Furthermore, in many cases, difficulties in establishing an accurate intraoperative diagnosis have resulted in a two-stage surgical intervention. We herein report a case of a primary appendiceal mucinous adenocarcinoma in a 67-year-old Caucasian man who presented with atypical symptoms of persistent coughing and weight loss. The chest CT showed lesions with features favorable of malignancy. Further investigation with abdominal CT and colonoscopy revealed a large tumor of the cecum expanding to the ascending colon. Typical right hemicolectomy was performed and the histopathological examination confirmed mucinous adenocarcinoma of the appendix. As some cases are accidentally discovered, the presented case describes an extremely rare first presentation of this tumor and emphasizes that the preoperative diagnosis of appendiceal cancer is challenging due to the lack of specific symptoms and signs.
authors.affiliation: First Surgical Department, 417 NIMTS Military Veterans' Fund Hospital of Athens, Greece.
authors.forename: Stavros
authors.initials: S
authors.lastname: Gourgiotis
authors.affiliation: First Surgical Department, 417 NIMTS Military Veterans' Fund Hospital of Athens, Greece.
authors.forename: Christianna
authors.initials: C
authors.lastname: Oikonomou
authors.affiliation: First Surgical Department, 417 NIMTS Military Veterans' Fund Hospital of Athens, Greece.
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Kollia
authors.affiliation: First Surgical Department, 417 NIMTS Military Veterans' Fund Hospital of Athens, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Falidas
authors.affiliation: First Surgical Department, 417 NIMTS Military Veterans' Fund Hospital of Athens, Greece.
authors.forename: Constantinos
authors.initials: C
authors.lastname: Villias
keywords: Adenocarcinoma; Appendix; Coughing; Diagnosis; Mucinous