Primary Appendicular Malignancy Presenting as Abdominal Wall Abscess with Secondary Tuberculosis Infection: an Interesting Case Report

Cancers of the appendix are rare. Most of them are found accidentally on appendectomies performed for appendicitis. When reviewed, majority of the tumors were carcinoid, adenoma, and lymphoma. Adenocarcinomas of the appendix are only 0.08% of all cancers, and the treatment remains controversial. It can present as appendicitis or lump or abscess. Gastrointestinal tuberculosis most commonly involves the ileocecal region. Disruption of the integrity of mucosal barriers and impairment in cell-mediated immunity associated with cancerous growth are known to predispose to bacterial infection. The role of antituberculosis therapy and chemotherapy is unclear due to lacking randomized trials but seems to be accepted if there is lymph node involvement or peritoneal seeding. Here, we are reporting a 69-year-old lady presented with symptoms of abdominal wall abscess with tuberculosis infection which was then diagnosed with mucinous adenocarcinoma of the appendix. The patient was treated with incision and drainage followed by the right hemicolectomy. Up to date, she remains asymptomatic and continuing with chemotherapy.