Abstract:
Low-grade appendiceal mucinous neoplasm (LAMN) is principally characterized by low-grade cytology without evidence of invasion to other organs. We report a LAMN surgical case whose appendiceal tumor penetrated the sigmoid colon wall. An 87-year-old man was referred for endoscopic resection (ER) of a colon polyp. Despite four ERs over 5 years, the polyp recurred at the same site. Laparoscopic surgery revealed a dilated appendix firmly attached to the sigmoid colon. We performed en bloc resection of both the sigmoid colon and appendix without tumor exposure. The histopathological evaluation showed that the LAMN had penetrated the sigmoid colon wall, forming two polyps on the colonic mucosa. In cases where the appendiceal-colonic fistula is suspected, en bloc resection of the appendix and colon wall should be considered.
摘要:
低级阑尾黏液性肿瘤(LAMN)的主要特征是低级细胞学检查,没有侵袭其他器官的证据。我们报告了一个LAMN手术病例,其阑尾肿瘤穿透了乙状结肠壁。一名87岁的男子被转诊为结肠息肉的内窥镜切除术(ER)。尽管五年来有四次ER,息肉在同一部位复发。腹腔镜手术显示扩张的阑尾牢固地附着在乙状结肠上。我们对乙状结肠和阑尾进行了整块切除,没有肿瘤暴露。组织病理学评估显示,LAMN已穿透乙状结肠壁,在结肠粘膜上形成两个息肉。如果怀疑阑尾结肠瘘,应考虑对阑尾和结肠壁进行整块切除.