Caecal Adenocarcinoma in a Patient Mimicking Complicated Appendicitis

Colorectal cancer (CRC) presenting with intestinal obstruction is uncommon in paediatric age and carries poor prognosis. We report a case of a 13-year-old boy who presented with acute intestinal obstruction, clinically appearing to be secondary to complicated appendicitis. Exploratory laparotomy revealed a caecal mass which was resected. Histopathology report showed only inflammatory cells with no sign of malignancy. The patient was discharged home after smooth recovery but re-admitted after 2 months with recurrence of intestinal obstruction. Considering clinical behavior of the patient, the tissue blocks obtained from first surgery were reviewed and it turned out to be a poorly differentiated adenocarcinoma with positive mesenteric lymph nodes for metastatic carcinoma.