Appendicitis and ileal neuroendocrine tumor, a Surprising diagnostic coincidence: case report

Meryem Raoui; Mariam Miara; Houria Tabakh; Youssef Sakhy; Abdellatif Siwane; Najwa Touil; Omar Kacimi

doi:10.5455/ajdi.20251021040751

Abstract
We present the case of a 51-year-old woman who presented to the emergency department with right iliac fossa pain.
Clinical examination and laboratory results indicated acute appendicitis.
However, an abdominal CT scan with contrast revealed an endoluminal budding nodule at the level of the last ileal loop, the scannographic appearance and character of which were highly suggestive of a neuroendocrine tumour (NET), associated with the presence of appendicitis of reactive appearance.
Diagnostic confirmation of neuroendocrine tumor of the last ileal loop was obtained by anatomopathological analysis of the surgical specimen.
This case highlights the diagnostic value of cross-sectional imaging in the context of non-specific abdominal symptoms, facilitating the incidental detection of clinically silent but potentially significant neoplastic processes, such as ileal NETs, which are often diagnosed late due to their indolent nature and non-specific presentation.

Key words: Neuroendocrine tumor- Terminal ileum- Incidental finding- Appendicitis- Abdominal pain- Ileal neoplasm- Reactive appendicitis