A case of primary adenocarcinoma of the appendix with metastasis to both ovaries was
reported.
A 23 years old korean female was admitted to the department of Ob. & Gy. in BNUH,
1975, because of fever, chill and lower abdominal pain. She had experienced two artificial
abortions, the last one performed 17 days prior to admission.
On physical examination at admission, a double adult fist-sized mass was noticed in the
posterior fornix on palpation and it was attached to the posterior part of the uterus. A
plain x-ray of the abdomen showed a space occupying mass in the lower abdomen and
pelvis. An operation was performed under the clinical diagnosis of adnexal tumor. On
operation, both ovaries were enlarged and adhered to the uterine wall and rectum.
Incidentally, there was also noticed a gray white discoloration in the distal third of the
appendix and a small nodular mass in the tip on close examination. Both
salphingo-oophorectomies and appendectomy were performed. The patient was expired
23 months after the operation.
Grossly, there was a gray white discoloration in the distal third of the appendix which
had a small gray white nodule at the tip. On cut surface the lumen of the appendix was
filled with gray white tissue, and the thickened wall also appeared gray white. The
right and left ovaries measured 10×7×3㎝ and 11×7×3㎝ in size respectively. Both
ovaries had brownish gray white and lobulated surface tinged by dark reddish
hemorrage. The cut surface of both ovarian tumors showed massive necrosis and
appeared dark yellow brown tissue in part with small cystic spaces. No ovarian tissues
could be seen in both ovarian tumors.
Histopathologically, sections from the distal third of the appendix showed neoplastic
glands extended from the mucosa through submucosa and muscle layer to the serosa.
There was the neoplastic cells invaded into vessels in the muscle and subserosa layers.
The neoplastic glands were lined by single to few layers of anaplastic columnar cells.
Sections from both ovarian tumors showed massive necrosis and in part non-necrotic
neoplastic columnar epithelial cells. Neoplastic glandular lumens were filled with a small
amount of mucinous material.
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