The presentation of a rare case for the attention of younger surgeons. Case Description: A 56 year old female patient who underwent open appendectomy. Appendiceal adenocarcinoma accounts for < 0.5% of all gastrointestinal neoplasms. it is extremely difficult to diagnose prior to surgical inspection, and it usually depends on the pathology following appendectomy . Due to the small sample size and range of clinical presentations, the diagnosis of appendiceal carcinoma remains challenging for physicians. Although some literatures associated with mucinous adenocarcinoma of the appendix have been reported, there are few reports about its treatment after relapse based on literature search results Here, we report such a case, in which the patient underwent the surgery three times associated with the appendiceal adenocarcinoma and review the relevant literature.