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小儿腹膜假黏液瘤:一例报告及文献复习

Pseudomyxoma peritonei in a pediatric patient: A case report and literature review.

作者信息

Fernandes Ana Claudia de Oliveira, Rocha Gustavo Ricardo Martins da, Oliveira Alex Dias de, Guimarães Marcos Duarte, Carvalho Stefane Cajango de, Chojniak Rubens

机构信息

Department of Radiology and Imaging Diagnosis, Hospital A.C. Camargo Cancer Center, São Paulo, SP, Brazil.

出版信息

Rev Assoc Med Bras (1992). 2018 Feb;64(2):195-199. doi: 10.1590/1806-9282.64.02.195.

DOI:10.1590/1806-9282.64.02.195
PMID:29641675
Abstract

INTRODUCTION

Pseudomyxoma peritonei (PMP) is a rare clinical condition, with an incidence of 1-2 cases per million, characterized by the dissemination of mucinous implants on the peritoneal surface and progressive gelatinous ascites. Although it usually presents an indolent behavior, its non-specific clinical presentation contributes to many cases remaining undiagnosed until a laparotomy is performed. With late diagnosis, performed after a long period of clinical deterioration and disease progression, it is common to find complications such as the formation of intestinal fistulas and obstruction.

METHOD

Review of the medical record and search for references in the Medline, Lilacs, SciELO and MD Consult databases.

RESULTS

There are rare case reports found in the literature demonstrating atypical PMP presentations. Our report is that of a 17-year-old adolescent with a sporadic tumor diagnosed in a primary site in the transverse colon, contrary to data commonly found in the literature that mention a more frequent occurrence in women in the fifth decade of life and with a primary site in the ovary and appendix. The development of mucinous adenocarcinoma is rare in the pediatric population, and topography in the transverse colon and non-familial sporadic pattern are unusual.

CONCLUSION

The case reported not only raises awareness about the atypical presentations of the disease, but also emphasizes the use of imaging examinations for diagnosis, which has an important impact on prognosis and survival if performed timely.

摘要

引言

腹膜假黏液瘤(PMP)是一种罕见的临床病症,发病率为百万分之一至二,其特征为黏液性种植体在腹膜表面播散以及渐进性胶冻样腹水。尽管它通常表现为惰性病程,但其非特异性临床表现导致许多病例在进行剖腹手术之前仍未得到诊断。由于诊断较晚,即在长期临床恶化和疾病进展之后才进行诊断,常见的并发症如肠瘘形成和肠梗阻很常见。

方法

回顾病历并在医学在线数据库(Medline)、拉丁美洲和加勒比地区健康科学文献数据库(Lilacs)、科学电子图书馆在线数据库(SciELO)和医学数据库咨询公司数据库(MD Consult)中检索参考文献。

结果

文献中发现罕见的病例报告显示了非典型的PMP表现。我们的报告是关于一名17岁青少年,其在横结肠的原发部位诊断出散发性肿瘤,这与文献中通常提到的情况相反,文献中提到在50岁左右的女性中更为常见,且原发部位在卵巢和阑尾。黏液腺癌在儿科人群中很少见,横结肠的部位以及非家族性散发性模式都不常见。

结论

所报告的病例不仅提高了对该疾病非典型表现的认识,还强调了影像学检查在诊断中的应用,如果及时进行,对预后和生存有重要影响。

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