An incidental finding of metastatic gastric cancer to the appendix during diagnostic laparoscopy. A case report and review of the literature.

Abstract Purpose: Gastric cancer is the 6th most common cancer and is a leading cause of death worldwide. Metastases to the appendix is a rare clinical entity of gastric cancer and only 10 cases are reported in the literature to date. Methods / Results: We present a case of a 74 year-old female who underwent a diagnostic laparoscopy prior to a planned gastric cancer resection for a gastric adenocarcinoma. The appendix was incidentally noted to be macroscopically abnormal during the procedure and was subsequently resected. This was found to contain a metastatic deposit of gastric adenocarcinoma. This resulted in an upstaging of the patient’s cancer and, systemic treatment became the management of choice. Conclusion: This case highlights the importance of diagnostic laparoscopy as part of staging in gastric cancer and underscores the need for a thorough examination, as appendiceal metastasis can be easily missed if not specifically assessed for or not found on work-up imaging.