A rare pathological triad unmasked by typhoid enteritis: report of a case of acute appendicitis, appendiceal schistosomiasis and villous adenoma of the appendix.

Abstract

A villous adenoma of the appendix is an extremely rare tumour of the appendix even rarer is its occurrence on schistosomal granulomatous appendicitis. It is therefore usually an incidental finding during appendicectomy. Most series on appendiceal tumours accounts for less than 7% as villous adenomas. The index case histologically shows acute appendicitis, schistosomal granulomata and a villous adenoma. There may be an aetiological relationship between schistosomiasis and the villous adenoma of the appendix in this case since schistosoma related colonic squamous cell carcinomas have been observed in endemic arrears. Treatment is limited to appendicectomy and praziquantel therapy but post-operative colonoscopy is recommended due to the risk of colonic schistosomiasis and malignancy in patients with appendiceal neoplasms. We therefore report this rare pathological triad.