Difficult diagnosis: acute appendicitis and carcinoma of the appendix/caecum

Introduction: Primary carcinoma of the appendix vermiformis/caecum is very rare. The diagnosis can often be ascertained only post-operatively by histopathological means. Preoperative diagnosis is unusual. Method and results: We report on five patients with an adenocarcinoma of the appendix/base of caecom, all operated on between July 1998 and October 1999. Conclusion: A hemicolectomy "en principe" is not necessary. However, ileocaecal resection should have been performed during the first operation and there should be no positive lymph nodes. Postoperative diagnosis of a carcinoma after simple appendectomy necessitates Reoperation with right hemicolectomy.