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Abstract：
BACKGROUND: The incidence of mucinous appendiceal adenocarcinomas (MAA) has increased over the past three decades. Advanced stage tumor diagnosis is likely attributable to non-specific findings. Here we describe advanced stage appendiceal MAA presenting as inguinal ulcers, scrotal abscesses, and other nonspecific symptoms. To our knowledge, this is the first report of MAA presenting as inguinal pain with inflamed phlegmonous tissue and scrotal abscess.
METHODS: A 67-year-old male presented to a rural facility complaining of weight-loss, fatigue, hematuria, dysuria, painful right inguinal ulceration, and right scrotal abscess drainage. Computed tomography of the abdomen and pelvis revealed a distended appendix (> 1.3 cm) and a fistula between the appendix, urinary bladder, right scrotum, and right groin. Laparoscopic appendectomy was performed and diagnosed as MAA. After a right hemicolectomy, the MAA was staged as pT3b pN0 M0 G2.
CONCLUSIONS: This case highlights a unique presentation of late stage appendiceal MAA. Due to the increased incidence of appendiceal MAAs, reports of unique clinical features are needed to facilitate early diagnosis and intervention, especially in rural settings with limited access to specialists.
METHODS: A 67-year-old male presented to a rural facility complaining of weight-loss, fatigue, hematuria, dysuria, painful right inguinal ulceration, and right scrotal abscess drainage. Computed tomography of the abdomen and pelvis revealed a distended appendix (> 1.3 cm) and a fistula between the appendix, urinary bladder, right scrotum, and right groin. Laparoscopic appendectomy was performed and diagnosed as MAA. After a right hemicolectomy, the MAA was staged as pT3b pN0 M0 G2.
CONCLUSIONS: This case highlights a unique presentation of late stage appendiceal MAA. Due to the increased incidence of appendiceal MAAs, reports of unique clinical features are needed to facilitate early diagnosis and intervention, especially in rural settings with limited access to specialists.
摘要：
背景：在过去的三十年中，粘液性阑尾腺癌（MAA）的发病率有所增加。晚期肿瘤诊断可能归因于非特异性发现。在这里，我们描述了晚期阑尾MAA表现为腹股沟溃疡，阴囊脓肿,和其他非特异性症状。据我们所知,这是首次报道MAA表现为腹股沟疼痛伴炎症组织和阴囊脓肿。
方法：一位67岁的男性出现在农村设施，抱怨减肥，疲劳,血尿,排尿困难,痛苦的右腹股沟溃疡，右阴囊脓肿引流.腹部和骨盆的计算机断层扫描显示阑尾扩张（>1.3cm）和阑尾之间的瘘管，膀胱,右阴囊,和右腹股沟.行腹腔镜阑尾切除术，诊断为MAA。右半结肠切除术后,MAA分级为pT3bpN0M0G2。
结论：该病例突出了晚期阑尾MAA的独特表现。由于阑尾MAAs的发病率增加，需要报告独特的临床特征，以促进早期诊断和干预，特别是在农村地区，专家的机会有限。
方法：一位67岁的男性出现在农村设施，抱怨减肥，疲劳,血尿,排尿困难,痛苦的右腹股沟溃疡，右阴囊脓肿引流.腹部和骨盆的计算机断层扫描显示阑尾扩张（>1.3cm）和阑尾之间的瘘管，膀胱,右阴囊,和右腹股沟.行腹腔镜阑尾切除术，诊断为MAA。右半结肠切除术后,MAA分级为pT3bpN0M0G2。
结论：该病例突出了晚期阑尾MAA的独特表现。由于阑尾MAAs的发病率增加，需要报告独特的临床特征，以促进早期诊断和干预，特别是在农村地区，专家的机会有限。
