Appendiceal Goblet Cell Carcinoma: Role of Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Goblet cell carcinoma (GCC) encompasses a separate entity in appendiceal neoplasms with mixed glandular and neuro-endocrine pathological features. GCC mostly presents as an acute appendicitis duo to luminal obstruction or as an incidental finding on the surgical appendectomy specimen. In case of tumour perforation or presence of other risk factors, guidelines suggest additional treatment with a completing right hemicolectomy or cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). We report the case of a 77-year-old male with symptoms of appendicitis for which an appendectomy was performed. The appendix was ruptured during the procedure. There was an incidental finding of GCC on the pathological specimen. Because of possible tumour soiling, the patient received a prophylactic CRS-HIPEC. A literature review was performed to investigate the potential role for CRS-HIPEC as a curative treatment in patients with GCC. GCC of the appendix is an aggressive type of tumour with a high risk of peritoneal and systemic dissemination. CRS and HIPEC is a treatment option: both in a prophylactic setting and in patients with established peritoneal metastases.

Automated summary

Goblet cell carcinoma (GCC) is a distinct entity in appendiceal neoplasms with mixed glandular and neuro-endocrine features. It can present as acute appendicitis or an incidental finding on surgical pathology. Additional treatment with CRS-HIPEC is recommended for perforation or other risk factors. We report a case of GCC in a 77-year-old male who underwent appendectomy for appendicitis, with incidental finding of GCC. Prophylactic CRS-HIPEC was performed due to possible tumor soiling. A literature review suggests that CRS-HIPEC can be a curative treatment option for GCC.