A case report of bone metastases from appendiceal adenocarcinoma and a review of literature

Appendiceal adenocarcinoma (AA) is a rare cancer, accounting for less than 0.5% of all gastrointestinal cancers. As such, there is still debate surrounding both the nature of the disease and the roles of different treatment modalities in the care of this patient population. Metastases of AA, particularly distant metastases, have not been explored extensively in literature. As survival in optimally treated cases of AA continues to improve, clinicians may encounter previously unrealized complications of this disease or unlikely metastases at a higher frequency. We reported the rare case of a 50-year-old male with recurrent mucinous AA who developed painful pelvic bone metastases. To palliate his symptoms, the patient underwent 30 Gy of external beam radiation treatment (EBRT) in 10 fractions to the pelvis. The patient achieved a good pain response after completion of EBRT, with elimination of analgesic use one month post-treatment. This case demonstrates successful palliative management of bone metastases from a primary mucinous AA. Although there is a lack of evidence-based guidelines specific to the treatment of AA, there are a variety of therapies available [e.g., chemotherapy, cytoreductive surgery (CRS), radiation, etc.]. The use of these treatments is largely determined by prognostic factors.