Mucinous Appendiceal Adenocarcinoma Penetrated the Quadratus Lumborum Muscle Posteriorly and Presented as Gluteal Abscess Managed Aggressively with Drainage Followed by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Combined with Intraoperative Radiotherapy. a Case Report and Review of the Literature

Ayman Zaki Azzam; Fatimah Hassan Al-Hamadah; Kareem Ayman Azzam; Tarek Mahmoud Amin

doi:10.1007/s13193-020-01090-x

Mucinous Appendiceal Adenocarcinoma Penetrated the Quadratus Lumborum Muscle Posteriorly and Presented as Gluteal Abscess Managed Aggressively with Drainage Followed by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Combined with Intraoperative Radiotherapy. a Case Report and Review of the Literature

Indian J Surg Oncol. 2020 Sep;11(Suppl 1):128-130. doi: 10.1007/s13193-020-01090-x. Epub 2020 May 21.

Authors

Ayman Zaki Azzam^{1

2}, Fatimah Hassan Al-Hamadah², Kareem Ayman Azzam³, Tarek Mahmoud Amin²

Affiliations

¹ General Surgery Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
² Surgical Oncology Department, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
³ Cheeloo College of Medicine, Shandong University, Jinan, Shandong China.

Abstract

Appendiceal mucinous adenocarcinoma is a term that was given for invasive appendiceal tumors. It is always present with pseudomyxoma peritonei which is a complex disease. These tumors have the tendency to surround the primary tumor then extend primarily and extensively all over the peritoneal cavity as the primary site of metastases. The invasion through the abdominal wall muscles is rare but the penetration and passing through these muscles to the subcutaneous tissue are extremely rare. A 62-year-old male patient known to have pseudomyxoma peritonei presented with gluteal abscess. After 2 weeks from the abscess drainage, the patient underwent cytoreductive surgery (CRS) combined with intraoperative radiotherapy (IORT) and hyperthermic intraperitoneal chemotherapy (HIPEC). He tolerated the operation well and discharged home in a good condition. Even with extensive appendiceal mucinous neoplasms presented with the penetration of the abdominal wall muscles, still aggressive management should be considered.

Keywords: Cytoreductive surgery; Gluteal abscess; Hyperthermic intraperitoneal chemotherapy; Intraoperative radiotherapy; Mucinous appendiceal adenocarcinoma; Quadratus lumborum muscle.