Apendicite aguda como manifestação inaugural de neoplasia gástrica

O. Castelbranco¹, M. Fortunato², M. Smit³, H. L. da Silva¹, L. Costa⁴, P. Costa¹

 

Resumo

A propósito de um caso clínico de apendicite aguda como manifestação inaugural de neoplasia gástrica, faz-se uma revisão sobre tumores do apêndice. As metástases apendiculares são entidades clínicas particularmente raras, o que condiciona dificuldade na marcha diagnóstica e estratégia terapêutica a adoptar. A revisão bibliográfica de casos similares permitiu sugerir uma abordagem diagnóstica de doentes com apresentações clínicas análogas.

A baixa prevalência de metástases apendiculares com origem num adenocarcinoma gástrico e cuja apresentação inicial seja um quadro de apendicite aguda justifica a presença de apenas quatro casos idênticos registados na literatura médica. Este facto não deve, porém, obviar a suspeição de neoplasia subjacente em doentes oncológicos com apendicite aguda.

 

 

Summary

A case study on gastric cancer, initially presented as acute appendicitis, made us examine tumours on the appendix. Cases of appendicular metastasis are very rare which gives rise to difficult diagnostic and therapeutic management. Comparisons of other case reports allowed us to equate the diagnostic investigations that could be done in similar cases, even though we found only four reports of gastric cancer presenting as acute appendicitis in medical literature.

The rarity of this case study shouldn´t preclude suspicions of metastasis in patients with acute appendicitis and a previous history of cancer.

 

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⁽¹⁾ Serviço de Cirurgia III.

⁽²⁾ Serviço de Radioterapia.

⁽³⁾ Serviço de Anatomia Patológica.

⁽⁴⁾ Serviço de Oncologia Médica.

Hospital de Santa Maria, Lisboa, Portugal/Faculdade de Medicina de Lisboa.

e-mail: rdd29757@mail.telepac.pt

 

 

Recebido para publicação: 08/07/2005

Aceite para publicação: 11/11/2005