PRIMARY adenocarcinoma of the appendix, excluding carcinoid tumors, is considered to be a rare disease, so infrequent in fact that many surgeons have never seen a case during their lifetime. The following case is presented because of the confusing pathological picture and the problem of surgical management. REPORT OF A CASE This case is that of a 26-year-old white woman, a housewife. Her past medical history included two normal pregnancies and one therapeutic abortion. In December, 1950, she had been hospitalized with infectious hepatitis. This was one year prior to the illness being reported here. It is of interest that after recovery from hepatitis the patient complained of some vague right lower quadrant abdominal distress. A colon x-ray study was done at that time, March, 1951, and was thought to reveal slight narrowing of the tip of the cecum along its medial aspect. However, reexamination four days later by means