Appendiceal Adenocarcinoma Arising after Bone Marrow Transplantation for Non-Hodgkin Lymphoma: An Unusual Treatment Dilemma

Appendiceal tumors are rare neoplasms occurring in approximately 0.1% of appendectomy specimens1. The majority present as acute appendicitis and are treated by simple appendectomy. Although controversial, in the setting of peritoneal carcinomatosis discovered at the time of appendectomy, cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) may represent potential therapeutic options. However, debate exists with regard to patient selection, quality of life and procedureassociated morbidity, what constitutes effective cytoreduction, and whether cytoreduction alone offers a survival benefit in the absence of intraperitoneal chemotherapy. This report describes a rare case of a perforated appendiceal adenocarcinoma arising after bone marrow transplantation for non-Hodgkin lymphoma. The occurrence of peritoneal carcinomatosis in this setting has not previously been reported, but exemplifies the importance of an individualized approach to therapy based on a patient’s presentation.