Metastatic involvement of ceco-appendicular segment: A diagnosis of right lower quadrant abdominal pain in patient receiving chemotherapy

Metastases are a common feature during the evolution of breast cancer. Howe ver, gastrointestinal metastases, and especially ceco-appendicular ones, ar e very rare. Melanoma however frequently metastasize in the gastrointestina l tract. Ceco-appendicular metastases do not display any specific signs in cancerous patients. These rare metastases must be considered in the diagnosis of right lower qu adrant pain in cancerous patients. The main differential diagnosis includes neutropenic enterocolitis, acute appendicitis, malignant intestinal obstru ction and perforation of the bowel. The morbidity of gastrointestinal compl ications in patients with metastatic cancer receiving chemotherapy is signi ficant and surgery is often the only chance of survival. The major clinical decision is whether or not to operate.