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PARTIAL COLECTOMY ASSOCIATED WITH ABDOMINAL WALL RECONSTRUCTION WITH MYOCUTANEOUS FLAP IN APPENDIX ADENOCARCINOMA
Apresentação do caso
A 52 year-old male patient appeared in the Emergency Department complaining of severe right-sided abdominal pain. He was diagnosed with appendicitis and underwent conventional appendectomy. A visible and palpable mass appeared in the lumbar region and drainage of the abdominal wall necrosis was performed. He was examined by the Surgical Oncology team, which found a mucus-secreting tubular Adenocarcinoma. He underwent chemotherapy with six cycles of BFOL, being discharged after completing the cycles on 04/12/2019. Presented recurrence of wall tumor in 2020, with serosanguinous discharge, with voluminous tumor in abdominal wall exterior in the right flank, followed by surgical approach. Partial colectomy in the right side with lymphadenectomy of the superior mesenteric vascular trunk and resection of the abdominal wall was performed. The plastic surgery team conducted VRAM myocutaneous flap dissection of the right hemiabdomen. Internal rotation of the flap to the region of the complete defect of the right flank abdominal wall. By the study of the material removed + subsidiary examinations, it was staged as Pt4N0PM1c.
Adenocarcinoma of the appendix occurs in males over the age of 50. They present signs that suggest appendicitis. The conclusive diagnosis is reached in the postoperative period through microscopic examination (anatomopathological), and together with imaging tests the diagnosis (Tomography and Ultrasonography) is possible. The performance of right hemicolectomy, and chemotherapy are the main approaches to stage 3 colon cancer, this procedure was chosen by the hospital team.
The adenocarcinoma of the appendix observed in a 50 year-old male patient presented similar symptoms to appendicitis. As for the differential diagnosis, the described report and the literature review allow us to affirm that the complementary exams together with the anatomopathological findings are helpful in order to find the correct diagnosis. The most effective therapeutic approach has been the right hemicolectomy.
Adenocarcinoma of the appendix, partial Colectomy, abdominal wall reconstruction.
RAFAELA CASSIA DA CUNHA PEDROSO, LAÍSE DE PAULA MAITELLI, CELINA DOS SANTOS ALENCASTRO, LUCAS BERTOLIN, LUIZ HENRIQUE SILVA BORGES, LAUZAMAR ROGER MARTINS, BIANCA LELLIS MARTINS , RAFAEL SODRÉ DE ARAGÃO