A 59-year-old male came to the Emergency Department after 24 h of generalized abdominal pain in the right iliac fossa. He reported no gastrointestinal disturbances and fever of 37.5°C. Lab work showed CRP 125 mg/L. Urgent contrast-enhanced CT scan of the abdomen revealed a microperforated mucocele of the appendix with fluid around the appendix and in the right paracolic gutter (Fig. 1).
The case was discussed with the Tumor Committee, which decided on surgery with radical intent.
Surgical intervention: a large, calcified (porcelain) appendiceal neoplasm was observed with retrocecal extension, closely adhered to the right parietal peritoneum (Fig. 2). We performed right hemicolectomy + paracolic and right pelvic peritonectomy + omentectomy.
The pathology results reported an appendix compatible with malakoplakia. Lymph nodes were negative.
