Early appendiceal adenocarcinoma. A review of the literature with special reference to optimal surgical procedures.

A rare case of early colonic adenocarcinoma of the appendix confined to the mucosa is reported. The patient remained well 5 years after simple appendectomy. We also review the Japanese literature on early colonic adenocarcinoma of the appendix. Twenty-seven cases of early colonic adenocarcinoma of the appendix, including ours, have been reported in Japan. In 20 of these patients, right hemicolectomy or ileocecal resection was performed. Eighteen patients were available for lymph node evaluation. Lymph nodes were negative for metastasis in 17 of the 18. Only one patient, with poorly differentiated adenocarcinoma invading the submucosa, had lymph node metastases. Our study shows that well-differentiated adenocarcinoma invading the submucosa, or adenocarcinoma of any differentiation confined to the mucosa, may be feasibly treated with simple appendectomy.