Shiihara Masahiro, Ohki Takeshi, Yamamoto Masakazu
Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
Case Rep Gastroenterol. 2017 Sep 15;11(3):539-544. doi: 10.1159/000480374. eCollection 2017 Sep-Dec.
We report a case of appendiceal mucinous cystadenoma that was successfully diagnosed preoperatively and treated by laparoscopic resection. We could find volcano sign on colonoscopy and cystic lesion without any nodules at the appendix on computed tomography (CT). Without any malignant factors in preoperative examinations, we performed laparoscopic appendectomy including the cecal wall. We could avoid performing excessive operation for cystadenoma with accurate preoperative diagnosis and intraoperative finding and pathological diagnosis during surgery. Appendiceal mucocele is a rare disease that is divided into 3 pathological types: hyperplasia, cystadenoma, and cystadenocarcinoma. The surgical approaches for it remain controversial and oversurgery is sometimes done for benign tumor, because preoperative diagnosis is difficult and rupturing an appendiceal tumor results in dissemination. Based on our study, volcano sign on colonoscopy and CT findings were important for the preoperative diagnosis of appendiceal mucocele. Furthermore, we think that laparoscopic resection will become a surgical option for the treatment of appendiceal mucocele.
我们报告一例阑尾黏液性囊腺瘤，术前成功诊断并通过腹腔镜切除术进行治疗。我们在结肠镜检查中发现了火山征，计算机断层扫描（CT）显示阑尾处有囊性病变且无任何结节。由于术前检查未发现任何恶性因素，我们进行了包括盲肠壁在内的腹腔镜阑尾切除术。通过准确的术前诊断、术中发现及手术中的病理诊断，我们避免了对囊腺瘤进行过度手术。阑尾黏液囊肿是一种罕见疾病，分为增生、囊腺瘤和囊腺癌3种病理类型。其手术方式仍存在争议，有时会因术前诊断困难且阑尾肿瘤破裂会导致播散而对良性肿瘤进行过度手术。基于我们的研究，结肠镜检查中的火山征和CT表现对阑尾黏液囊肿的术前诊断很重要。此外，我们认为腹腔镜切除术将成为治疗阑尾黏液囊肿的一种手术选择。
