Adenocarcinoma Ex-Goblet Cell Carcinoid of the Appendix With Metastatic Peritoneal Spread to Meckel's Diverticulum and Endometriosis

Int J Surg Pathol. 2017 Oct;25(7):623-628. doi: 10.1177/1066896917707042. Epub 2017 Apr 28.


Adenocarcinoma ex-goblet cell carcinoid is a very rare and histologically unique appendiceal malignancy with dual glandular and neuroendocrine differentiation. There is a high incidence of this tumor among middle-aged women with metastasis to the gynecologic tract with the mode of metastasis following peritoneal spread rather than hematogenous distribution. Adenocarcinoma ex-goblet cell carcinoid can spread to any peritoneal site including ovaries or omentum. We report a 37-year-old healthy woman who initially presented with right lower quadrant abdominal pain and pseudomyxoma peritonei. Histopathology of the appendectomy specimen revealed an adenocarcinoma ex-goblet cell carcinoid, signet ring cell type. Follow-up right hemicolectomy, omentectomy, bilateral salpingo-oophorectomy, and regional peritoneal resections revealed metastatic involvement by adenocarcinoma ex-goblet cell carcinoid, signet ring cell type. In this report, we describe a case of appendiceal adenocarcinoma ex goblet cell carcinoid with metastases to Meckel's diverticulum and areas of pelvic endometriosis, which have not been previously reported.

Keywords: Meckel’s diverticulum; adenocarcinoma ex goblet cell carcinoid; appendix cancer; endometriosis; signet ring cells.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / secondary*
  • Adenocarcinoma / surgery
  • Adult
  • Appendectomy
  • Appendiceal Neoplasms / pathology*
  • Appendiceal Neoplasms / surgery
  • Appendix / surgery
  • Biopsy
  • Carcinoid Tumor / secondary*
  • Colectomy
  • Endometriosis / pathology*
  • Endometriosis / surgery
  • Female
  • Humans
  • Ileal Neoplasms / secondary*
  • Ileal Neoplasms / surgery
  • Meckel Diverticulum / pathology
  • Omentum / pathology
  • Omentum / surgery
  • Ovary / pathology
  • Ovary / surgery
  • Peritoneal Neoplasms / secondary*
  • Peritoneal Neoplasms / surgery
  • Pseudomyxoma Peritonei / pathology*
  • Salpingo-oophorectomy