Complicated appendicitis as a rare presentation of Burkitt's lymphoma: a case report.

Burkitt lymphoma (BL) is an aggressive B-cell non-Hodgkin lymphoma that rarely involves the appendix and may mimic acute appendicitis, complicating preoperative diagnosis. In the context of nonoperative management for appendicitis, such malignancies risk being overlooked. A 32-year-old immunocompetent male presented with right upper quadrant pain, leukocytosis, cholestatic liver profile, and a hepatic lesion on imaging. Positron emission tomography-computed tomography (PET-CT) showed intense fluorodeoxyglucose uptake in the colon, liver, and peritoneum. Laparoscopy revealed an enlarged appendix (15 × 3 cm) with abscess; appendectomy was performed. Histopathology confirmed BL with a 'starry sky' pattern and Ki-67 of 95%. Appendiceal BL, though rare, should be suspected in atypical or complicated appendicitis, even without classic risk factors. Histopathological examination of appendectomy specimens is crucial. Surgery, even when not oncologic in intention, may lead to early cancer detection and timely systemic treatment, improving outcomes.