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阑尾黏液性囊腺瘤伴癌胚抗原(CEA)升高:两例报告并文献复习

Mucinous cystadenoma of the appendix presenting with an elevated carcinoembryonic antigen (CEA): Report of two cases and review of the literature.

作者信息

McFarlane M E C, Plummer J M, Bonadie K

机构信息

Department of Surgery, Radiology, Anaesthetics and Intensive Care, University of the West Indies, Mona, Jamaica.

出版信息

Int J Surg Case Rep. 2013;4(10):886-8. doi: 10.1016/j.ijscr.2013.07.007. Epub 2013 Aug 3.

Abstract

INTRODUCTION

Despite the fact the mucocoele of the appendix is a rare entity it has been the subject of much interest in the literature. The term mucocoele refers to cystic dilatation of the appendix filled with mucin resulting from proximal obstruction of the appendix lumen.

PRESENTATION OF CASE

We report two patients presenting with mucinous cystadenoma of the appendix with elevation of serum carcinoembryonic antigen (CEA), which has rarely been reported. Both patients had mild symptoms and a normal colonoscopy preoperatively. The diagnosis was not suspected in one patient prior to surgery. The elevated CEA prompted additional diagnostic radiologic investigations including ultrasonography, and computed tomography scans. The patients had uneventful appendicectomies with subsequent normalization of their CEA levels.

DISCUSSION

Mucinous cystadenoma of the appendix is a rare pathological entity characterized by a dilated mucous filled appendix. The presence of an elevated CEA associated with the presence of this entity is a rare presentation.

CONCLUSION

Because the diagnosis is rarely suspected prior to surgery patients with an enlarged appendix with associated elevated CEA levels should have careful investigations to exclude malignancy.

摘要

引言

尽管阑尾黏液囊肿是一种罕见的病症,但它一直是文献中备受关注的主题。术语“黏液囊肿”指的是阑尾因管腔近端阻塞而充满黏液的囊性扩张。

病例介绍

我们报告了两名患有阑尾黏液性囊腺瘤且血清癌胚抗原(CEA)升高的患者,这种情况鲜有报道。两名患者术前症状均较轻,结肠镜检查正常。其中一名患者术前未怀疑该诊断。CEA升高促使进行了包括超声检查和计算机断层扫描在内的额外诊断性影像学检查。患者阑尾切除术后恢复顺利,CEA水平随后恢复正常。

讨论

阑尾黏液性囊腺瘤是一种罕见的病理实体,其特征为阑尾扩张并充满黏液。该实体伴有CEA升高的情况很少见。

结论

由于术前很少怀疑该诊断,对于阑尾肿大且CEA水平升高的患者,应进行仔细检查以排除恶性肿瘤。

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本文引用的文献

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Mucocele of the appendix.阑尾黏液囊肿
World J Surg. 2007 Mar;31(3):542-8. doi: 10.1007/s00268-006-0454-1.
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Dis Colon Rectum. 2001 Jul;44(7):1034-6. doi: 10.1007/BF02235492.
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Case report: Mucocele of the tip of the appendix.
Clin Radiol. 1998 Feb;53(2):149-50. doi: 10.1016/s0009-9260(98)80064-0.

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