Diverticular Peritonitis Revealing an Incidental Neuroendocrine Tumor of the Appendix: A Rare Case Report and Review of the Literature

Abstract

Three main histological types of appendicular tumor have been described: adenoma, carcinoma and endocrine tumor. Endocrine tumors are the most common, accounting for almost two-thirds of appendicular tumors. Adenomas and adenocarcinomas are rare and present two particularities: A predominant and frequent mucinous component, and a privileged peritoneal extension. We report the case of a 57-year-old patient, a chronic smoker with 30 pack-year. The patient was admitted to our department as an emergency patient with perforated sigmoidal diverticulitis. Clinically, the patient presented a hypogastric pain and generalized abdominal tenderness on examination, the CT scan showed a pneumoperitoneum with multiple sigmoidal diverticula the surgical exploration revealed a perforated sigmoidal diverticulum with an inflamed appendix with a normal base. In the light of this review of the literature, we would like to emphasize the importance of histological examination in the diagnosis of neuroendocrine tumors of the appendix, and to highlight the importance of intraoperative exploration, whatever the diagnosis.