Martinez Carlos Augusto Real, Cutovoi Júlia, Rossi Debora Helena, Meirelles Luciana Rodrigues, Ayrizono Maria de Lourdes Setsuko, Leal Raquel Franco, Coy Cláudio Saddy Rodrigues
Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Rua Tessália Vieira de Camargo, No. 126, Cidade Universitária "Zeferino Vaz", 13083-887 Campinas, SP, Brazil.
Gastrocentro, Universidade Estadual de Campinas, Rua Carlos Chagas, No. 420, Cidade Universitária "Zeferino Vaz", 13083-878 Campinas, SP, Brazil.
Case Rep Surg. 2015;2015:297450. doi: 10.1155/2015/297450. Epub 2015 Apr 22.
Introduction. Serrated adenomas of the appendix are rare and usually found during appendectomy or autopsies. The preoperative diagnosis of these tumors is uncommon. This report describes a case of a sessile serrated adenoma located in the appendix diagnosed by a screening colonoscopy and successfully treated by laparoscopic removal. Presentation of Case. An 86-year-old woman underwent colonoscopy to investigate the cause of her diarrhea, weight loss, and anemia. During the colonoscopy, an expansive and vegetating mass of 1.5 cm in diameter was identified, protruding through the appendicular ostium with slightly lateral growth to the cecum. The patient was referred for laparoscopic surgical resection due to the location of the lesion, which did not allow its removal by colonoscopy. She underwent wedge removal of the cecum without complications and was discharged on the 4th postoperative day. Histopathological examination showed the presence of a sessile serrated adenoma with an intramucosal adenocarcinoma. The patient is currently well one year after surgery, without endoscopic signs of relapse. Conclusion. Despite serrated adenomas being a possibility rarely described in appendix it should be recognized and properly treated because it is presenting a higher risk of cancer.
引言。阑尾锯齿状腺瘤罕见，通常在阑尾切除术或尸检时发现。这些肿瘤的术前诊断并不常见。本报告描述了一例通过筛查结肠镜诊断出位于阑尾的无蒂锯齿状腺瘤，并经腹腔镜切除成功治疗的病例。病例介绍。一名86岁女性接受结肠镜检查以探究其腹泻、体重减轻和贫血的原因。结肠镜检查期间，发现一个直径1.5厘米的扩展性、赘生性肿物，从阑尾开口处突出，向盲肠略有侧向生长。由于病变位置无法通过结肠镜切除，该患者被转诊接受腹腔镜手术切除。她接受了盲肠楔形切除术，无并发症发生，并于术后第4天出院。组织病理学检查显示存在无蒂锯齿状腺瘤伴黏膜内腺癌。该患者术后一年情况良好，无内镜下复发迹象。结论。尽管阑尾锯齿状腺瘤很少被描述，但因其具有较高的癌症风险，应予以认识并妥善治疗。
