Low-grade appendiceal mucinous neoplasm and endometriosis of the appendix
Low-grade appendiceal mucinous neoplasm and endometriosis of the appendix
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DOI：
10.1186/s12957-017-1294-1
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发表时间：
2017-12-19
影响因子：
3.2
通讯作者：
Moller, Mecker G.
中科院分区：
文献类型：
--
作者：
Klingbeil, Kyle D.;Azab, Basem;Moller, Mecker G.
背景：扩张、充满粘液的阑尾被称为阑尾粘液囊肿。它们是阑尾肿块的一种罕见形式，由良性和恶性过程发展而来。粘液囊肿可继发于阻塞，例如粪便、疤痕或罕见的子宫内膜异位症。此前仅描述了 12 例由子宫内膜异位症引起的非肿瘤性阑尾粘液囊肿。本报告首次描述了肿瘤性阑尾粘液囊肿与子宫内膜异位症之间的关联。病例介绍：一名 57 岁女性，主诉过去 3 个月腹痛加剧。影像学检查显示阑尾肿块。腹腔镜评估证实阑尾粘液囊肿，患者接受了完整的阑尾切除术。腹腔内没有粘液或子宫内膜沉积物的证据。病理诊断显示低度阑尾粘液性肿瘤（LAMN），并有阑尾固有肌层子宫内膜异位的证据。患者康复后没有并发症，腹痛也完全缓解。结论：阑尾子宫内膜异位症是一种罕见的表现，通常被认为是偶然发现的。子宫内膜异位症导致阑尾阻塞性粘液囊肿是一种极其罕见的发现，在医学文献中仅描述了 12 次。本报告首次描述了存在阑尾子宫内膜异位症的 LAMN。阑尾肿瘤与子宫内膜异位症之间的关联需要进一步研究，以优化手术治疗。
Background: A distended, mucous-filled appendix is known as an appendiceal mucocele. They are a rare form of an appendiceal mass and develop from both benign and malignant processes. Mucoceles can develop secondarily to an obstruction, such as from a fecalith, scarring or, rarely, endometriosis. Only 12 cases of non-neoplastic appendiceal mucoceles caused by endometriosis have been previously described. The association between neoplastic appendiceal mucoceles in the presence of endometriosis is described for the first time in this report.Case presentation: A 57-year-old woman presented with a chief complaint of worsening abdominal pain over the past 3 months. Imaging studies revealed an appendiceal mass. Laparoscopic evaluation confirmed an appendiceal mucocele, and the patient underwent complete appendectomy. No evidence of mucinous or endometrial deposits were present within the abdominal cavity. Pathological diagnosis revealed low-grade appendiceal mucinous neoplasm (LAMN) with evidence of endometriosis within the muscularis propria of the appendix. The patient recovered without complications and her abdominal pain completely resolved.Conclusions: Endometriosis of the appendix is a rare manifestation and is most often identified as an incidental finding. Endometriosis leading to an obstructive mucocele of the appendix is an exceedingly rare finding, having only been described 12 times in the medical literature. LAMN in the presence of endometriosis of the appendix is described for the first time in this report. The association between appendiceal neoplasms in the presence of endometriosis requires further research in order to optimize operative treatment.