{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T19:42:33Z","timestamp":1792438953679,"version":"4.5.0"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Medullary adenocarcinoma is a rare colorectal carcinoma that may be difficult to recognize when inflammation dominates the presentation. A 65-year-old woman with a remote appendectomy presented with 1 month of postprandial abdominal pain, weight loss, and constipation. Repeated computed tomography demonstrated marked pericecal inflammation and a blind-ending structure interpreted as possible appendicitis despite her surgical history. Diagnostic laparoscopy identified an enlarged mesenteric lymph node, and excision unexpectedly showed metastatic medullary carcinoma of colonic origin with loss of MutL homolog 1 and PMS1 homolog 2 genes. Subsequent evaluation identified an ascending-colon primary. Right hemicolectomy confirmed a 1.5\u00a0cm poorly differentiated medullary adenocarcinoma, staged as pT2 pN1b, with negative margins. The patient remains clinically well during oncologic treatment. Persistent appendicitis-like inflammation, particularly when discordant with prior appendectomy, should prompt evaluation for cecal or ascending-colon malignancy.<\/jats:p>","DOI":"10.1093\/jscr\/rjag949","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T18:54:56Z","timestamp":1792436096000},"source":"Crossref","is-referenced-by-count":0,"title":["Medullary adenocarcinoma of the ascending colon mimicking appendicitis after prior appendectomy"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1625-4553","authenticated-orcid":false,"given":"Ian L","family":"Cummings-Ruiz","sequence":"first","affiliation":[{"name":"General Surgery Department, Hospital San Lucas , 909 Ave Tito Castro, Ponce, PR 00716 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose O","family":"Nieves-Munoz","sequence":"additional","affiliation":[{"name":"General Surgery Department, Hospital San Lucas , 909 Ave Tito Castro, Ponce, PR 00716 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suheily","family":"Acevedo","sequence":"additional","affiliation":[{"name":"General Surgery Department, Hospital San Lucas , 909 Ave Tito Castro, Ponce, PR 00716 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo E","family":"Bola\u00f1os Avila","sequence":"additional","affiliation":[{"name":"General Surgery Department, Hospital San Lucas , 909 Ave Tito Castro, Ponce, PR 00716 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"2026101914545437300_ref1","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.humpath.2016.02.018","article-title":"Medullary carcinoma in the colorectum: a systematic review and meta-analysis","volume":"53","author":"Pyo","year":"2016","journal-title":"Hum Pathol"},{"key":"2026101914545437300_ref2","doi-asserted-by":"publisher","first-page":"2988","DOI":"10.1245\/s10434-014-4355-5","article-title":"Medullary colorectal carcinoma revisited: a clinical and pathological study of 102 cases","volume":"22","author":"Knox","year":"2015","journal-title":"Ann Surg Oncol"},{"key":"2026101914545437300_ref3","doi-asserted-by":"publisher","first-page":"101856","DOI":"10.1016\/j.suronc.2022.101856","article-title":"Medullary carcinoma of the colon: a comprehensive analysis of the National Cancer Database","volume":"45","author":"Jabbal","year":"2022","journal-title":"Surg Oncol"},{"key":"2026101914545437300_ref4","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.humpath.2016.12.013","article-title":"Diagnosing colorectal medullary carcinoma: interobserver variability and clinicopathological implications","volume":"62","author":"Lee","year":"2017","journal-title":"Hum Pathol"},{"key":"2026101914545437300_ref5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ijsu.2020.04.065","article-title":"The incidence of right-sided colon cancer in patients aged over 40 years with acute appendicitis: a systematic review and meta-analysis","volume":"79","author":"Hajibandeh","year":"2020","journal-title":"Int J Surg"},{"key":"2026101914545437300_ref6","doi-asserted-by":"publisher","first-page":"625","DOI":"10.5858\/arpa.2016-0554-CP","article-title":"Molecular biomarkers for the evaluation of colorectal cancer: guideline from the ASCP, CAP, AMP, and ASCO","volume":"141","author":"Sepulveda","year":"2017","journal-title":"Arch Pathol Lab Med"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/10\/rjag949\/72116149\/rjag949.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/10\/rjag949\/72116149\/rjag949.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T18:54:56Z","timestamp":1792436096000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjag949\/8943698"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":6,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10,4]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjag949","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10]]},"published":{"date-parts":[[2026,10]]},"article-number":"rjag949"}}