Goblet cell adenocarcinoma of the appendix: a rolling stone for long

Abstract

Appendiceal goblet cell adenocarcinoma (GCA) is a rare and aggressive epithelial neoplasm comprising goblet-like mucinous cells primarily and variable neuroendocrine cells. It is an amphicrine neoplasm with features of epithelial and neuroendocrine tumours, but behaves aggressively like an adenocarcinoma variant. GCA has undergone multiple name changes in the past; therefore, there have been inconsistencies in nomenclature, classification, reporting, and understanding of the pathology of the disease. Although it typically presents with features of acute appendicitis, it may sometimes present with subtle symptoms of gastrointestinal discomfort. In late stages, they may present with intestinal obstruction or as a metastatic ovarian mass. Diagnosis is possible only on histopathologic examination, which reveals goblet cell infiltration in sheets, singly scattered form, complex cribriform pattern, discrete clusters, and tubules. Our case report aims to increase awareness about GCA and its differential diagnosis and emphasise the need for a larger, elaborate study to bring consistency in GCA reporting. We report a rare case of metastatic high-grade appendiceal GCA in a 65-year-old female presenting with complete intestinal obstruction.