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It is mostly diagnosed as an incidental finding after appendicectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>An 81 year old male patient presented with bleeding per rectum in a background of previous rectal polyp, hypertension, diabetes and hypothyroidism. CECT of whole abdomen findings revealed thickening at the appendix and base of the caecum. Colonoscopy showed a sessile polypoid growth at appendicular orifice, at the base of the caecum. Laparoscopy confirmed the clinical suspicion of appendicular carcinoma and laparoscopy assisted radical right hemicolectomy was performed. Final histopathology revealed well differentiated adenocarcinoma of the appendix with no lymph node involvement (pT3N0M0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Patients with primary adenocarcinoma of the appendix present with features similar to acute appendicitis whereas anaemia or fresh bleeding per rectum is a rare presentation. Surgery is the mainstay of treatment, the extent of which will depend upon the stage. Tumours staged as T1 may be managed by appendicectomy alone provided the base is free and there are no lymphadenopathies. T2 or above require right hemicolectomy as chances of lymph node metastasis are high. Nodal involvement warrants the need for adjuvant chemotherapy. Distant metastasis to the peritoneum or liver and lungs is very rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While investigating unexplained anaemia or bleeding per rectum, full colonoscopic examination up to the appendicular orifice is important and if required, should be combined with CT scan of abdomen, to clinch the rare but possible and potentially curable diagnosis of appendicular carcinoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2021.106285","type":"journal-article","created":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T06:46:10Z","timestamp":1628145970000},"page":"106285","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Primary adenocarcinoma of the appendix presenting with fresh bleeding per rectum"],"prefix":"10.1097","volume":"86","author":[{"given":"Baijaeek","family":"Sain","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnab","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samir","family":"Bhattacharya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radha Raman","family":"Mondal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudip","family":"Haldar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shravasti","family":"Roy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-14-20260114","doi-asserted-by":"crossref","first-page":"3307","DOI":"10.1002\/cncr.10589","article-title":"Primary malignant neoplasms of the appendix: a population-based study from the surveillance, epidemiology and end results program, 1973\u20131998","volume":"94","author":"McCusker","year":"2002","journal-title":"Cancer"},{"key":"R2-14-20260114","first-page":"728579","article-title":"Cancers of the appendix: review of the literatures","volume":"2011","author":"Ruo","year":"2011","journal-title":"ISRN Oncol"},{"key":"R3-14-20260114","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1159\/000505482","article-title":"\u201cObscure\u201d appendiceal orifice polyps can be challenging to identify by colonoscopy","volume":"14","author":"Amini","year":"2020","journal-title":"Case Rep. 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