33-year-old man with a rare cancer of the appendix and small intestine, gets second lease of life

A 33-year- old resident of Mumbai, who was suffering from non-Hodgkin’s Lymphoma of the appendix and small intestine was successfully treated.

By: Arushi Bidhuri | Edited by: Arushi Bidhuri | | Published: March 2, 2021 2:42 pm

Acute appendicitis is a very common surgical problem that affects people in all age-groups. It commonly presents with pain in the right lower abdomen and may be accompanied by fever, vomiting, loss of appetite and diarrhoea or constipation. However, an appendix is a rare site of cancerous growth. A 33-year- old resident of Mumbai, encountered pain in right lower abdomen for more than a week a few months ago. Once the pain became unbearable, he visited Dr Aparna Govil Bhasker, Laparoscopic and bariatric surgeon at Saifee, Apollo Spectra and Namaha Hospitals, Mumbai. She successfully treated the young patient with non-Hodgkin’s Lymphoma of the appendix and small intestine. The patient underwent challenging laparoscopic surgery and chemotherapy to get back on track. Also Read - Cancer immunotherapy may cause skin-related side effects: Who are most likely to experiencing them?

Dr Aparna said, “On ultrasound examination, he was found to have an inflamed appendix with a mucocele (a condition in which appendix gets filled up with mucoid material). The CT scan of the abdomen revealed a tumour in the appendix as well as the small intestine. On further investigations and evaluation, the patient was found to have Non-Hodgkin’s type of lymphoma of the appendix and the small intestine (Ileum).” Also Read - Pancreatic cancer: Combination therapy may be able to suppress tumour growth significantly

What Is Lymphoma?

Lymphoma is cancer that develops in the infection-fighting cells of the immune system called lymphocytes. In lymphoma, these cells can grow out of control. Lymphomas are commonly seen in lymph nodes, spleen, thymus, bone marrow, and some other parts of the body. Primary lymphomas affecting the gastrointestinal (GI) tract (food pipe, stomach, small intestine, and large intestine) are very rare and constitute 1 to 4% of all cancers afflicting the GI tract. The others are adenocarcinomas, carcinoid tumours, and GI sarcomas. Lymphomas affecting the appendix are rare and usually found on testing of appendix specimens post appendicectomy surgery. They are seen in 0.015% of appendicectomy specimens. Most of the time, it is Non-Hodgkin’s lymphoma and is commonly seen in men. Also Read - Bladder cancer: This drug can reduce death risk in patients with this condition

How Is Lymphoma Treated?

Lymphomas can be treated with surgery or chemotherapy and the outcomes depend on the stage of the disease. Surgical resection is warranted if the tumour is causing symptoms like bleeding, perforation, intussusception or obstruction. In that case, the affected part needs to be resected and removed. Nowadays, most intestinal surgeries can be performed through key-hole or laparoscopic surgery. This leads to lesser pain and helps the patient to recover faster. Additionally, chemotherapy may be instituted as an adjuvant as per the advice of the oncologist.

Laparoscopy: An Effective Treatment For Lymphoma

“A surgery in the form of laparoscopic right hemicolectomy was performed soon after the diagnosis. This entails the removal of the distal part of the small intestine, appendix, and right side of the large intestine/colon) using the minimal access or laparoscopic technique. Laparoscopic surgery entails 3 to 4 tiny sub centimetre cuts through which the entire surgery can be performed. Laparoscopy has made surgery less painful. It leads to faster recovery, and patients are able to return to their routine activities much earlier. Nowadays, many GI surgeries can be performed through laparoscopic technique. In this case, the surgery lasted for 2.5 hours and was discharged from the hospital on the fourth day. His recovery was uneventful. The patient undertook six cycles of chemotherapy after that for completion of treatment.” said Dr Aparna.

Cancers of the small intestine and appendix are rare. Lymphomas are seen even more rarely. “However, patients must be aware of their symptoms. Pain in the abdomen, change in bowel habits, blood in stools, etc. is some of the symptoms that must be evaluated further. One must not ignore any new symptoms and must consult a doctor immediately. During the Covid-19 pandemic, many patients have been hesitant to come to visit their doctors or come to the hospital. In many instances, this has led to a delay in diagnosis which can affect the treatment outcomes adversely,” said Dr Aparna.

Published : March 2, 2021 2:42 pm

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