# Bowel pseudo-obstruction caused by goblet cell adenocarcinoma of the appendix: A case report

## TL;DR

A rare appendix tumor caused bowel pseudo-obstruction by invading nerve fibers, highlighting diagnostic challenges and poor prognosis.

## Contribution

This case report identifies goblet cell adenocarcinoma of the appendix as a rare cause of bowel pseudo-obstruction.

## Key findings

- The tumor infiltrated nerve plexus, impairing peristalsis and causing intestinal stenosis.
- Goblet cell adenocarcinoma of the appendix is rare and often misdiagnosed preoperatively.
- Surgery remains the primary treatment for this aggressive tumor.

## Abstract

Goblet cell adenocarcinoma of the appendix is a rare diagnosis with features of both adenocarcinomas and carcinoid tumors. Commonly presenting with chronic abdominal pain, appendicitis, or abdominal distention, it can also be incidentally discovered during appendectomies.

A 50-year-old man with right lower abdominal pain was admitted to our hospital, which is a critical care center. A computed tomography(CT) scan showed ileal narrowing, but endoscopy found no strictures. He was admitted with suspected bowel obstruction and improved with an ileal tube. Laparoscopic surgery revealed a tumor of the appendix. Histologically, he was diagnosed goblet cell adenocarcinoma, suggesting tumor infiltration of nerve fibers impairing peristalsis.

Goblet cell adenocarcinoma of the appendix has unique histology and a poor prognosis. Treatment typically involves surgery and chemotherapy. This case highlights challenges in preoperative diagnosis, with the tumor causing bowel pseudo-obstruction by invading the intestinal wall and nerve plexus. Extensive infiltration of Auerbach's plexus was observed, consistent with the length of intestinal stenosis.

This case describes goblet cell adenocarcinoma of the appendix leading to bowel pseudo-obstruction due to ileal end stenosis. It emphasizes the importance of considering this diagnosis in cases of bowel obstruction without an obvious mass.

•Goblet cell adenocarcinoma of appendix is a rare diagnosis and associated with a poor prognosis.•Surgery is the most common treatment of goblet cell adenocarcinoma of appendix.•Goblet cell adenocarcinoma of appendix is a rare cause of bowel pseudo-obstruction.

Goblet cell adenocarcinoma of appendix is a rare diagnosis and associated with a poor prognosis.

Surgery is the most common treatment of goblet cell adenocarcinoma of appendix.

Goblet cell adenocarcinoma of appendix is a rare cause of bowel pseudo-obstruction.