Youn Sang Il, Namgung Hwan, Yun Jeong Seok, Park Yun Jun, Park Dong-Guk
Department of Surgery, Dankook University School of Medicine, Cheonan, Korea.
Ann Coloproctol. 2015 Apr;31(2):74-8. doi: 10.3393/ac.2015.31.2.74. Epub 2015 Apr 30.
We report a case of a goblet-cell carcinoid tumor of the appendix which metastasized to the peritoneum and was treated by using cytoreductive surgery (CRS) with intraperitoneal chemotherapy. A 47-year-old male presented with chronic constipation and was diagnosed as having a rectal adenocarcinoma with a signet-ring-cell component under colonoscopy. Computed tomography suggested peritoneal metastases with diffuse nodular parietal peritoneal thickening of the entire abdomen and focal invasion of the upper rectum by a seeding mass. CRS with intraperitoneal chemotherapy was done under the diagnosis of a rectal adenocarcinoma with peritoneal metastases. The pathologic diagnosis was a goblet-cell carcinoid tumor of the appendix with peritoneal metastasis. The histological discrepancy between a peritoneal metastatic mass and a rectal mass was due to the mixed histological pattern of a goblet-cell carcinoid tumor. A metastatic mass may not share identical immunohistochemical characteristics from its origin. This histologic discrepancy necessitates caution in diagnosing a distant metastasis of a goblet-cell carcinoid tumor.
我们报告一例阑尾杯状细胞类癌肿瘤转移至腹膜，并采用细胞减灭术（CRS）联合腹腔内化疗进行治疗的病例。一名47岁男性因慢性便秘就诊，结肠镜检查诊断为直肠腺癌伴印戒细胞成分。计算机断层扫描提示腹膜转移，整个腹部弥漫性结节状腹膜增厚，上直肠有种植性肿块灶性侵犯。在诊断为直肠腺癌伴腹膜转移的情况下进行了CRS联合腹腔内化疗。病理诊断为阑尾杯状细胞类癌伴腹膜转移。腹膜转移肿块与直肠肿块之间的组织学差异是由于杯状细胞类癌肿瘤的混合组织学模式。转移肿块可能与其起源部位不具有相同的免疫组化特征。这种组织学差异在诊断杯状细胞类癌肿瘤的远处转移时需要谨慎。
