Kimura Yusuke, Machimoto Takafumi, Yasukawa Daiki, Aisu Yuki, Hori Tomohide
Department of Digestive Surgery, Tenri Hospital, 200 Mishima-cho, Tenri, Nara, 632-8552, Japan.
Surg Case Rep. 2018 Jun 15;4(1):59. doi: 10.1186/s40792-018-0467-7.
Appendiceal metastasis from lung cancer is rare. However, it often causes acute appendicitis that requires emergency surgery. We herein report a thought-provoking case of appendiceal metastasis from lung cancer.
A 71-year-old man was diagnosed with advanced lung cancer with multiple metastases and underwent chemotherapy. One month later, he developed acute appendicitis, and laparoscopic appendectomy was promptly performed. A swollen appendix and pus collection were observed during surgery. Histological analysis revealed an invasive adenocarcinoma in the appendix that infiltrated the mucosal, submucosal, and muscular layers. Positive immunostaining of thyroid transcription factor 1 indicated appendiceal metastasis of pulmonary adenocarcinoma, not a primary appendiceal malignancy. The postoperative course was uneventful, and the patient's pulmonary internist resumed continuous chemotherapy after surgery.
Although appendiceal metastasis from pulmonary adenocarcinoma is rare, it often results in acute appendicitis. Optimal therapy including emergency surgery should be performed without hesitation so that chemotherapy can be resumed as soon as possible.
肺癌的阑尾转移罕见。然而，它常引发需要急诊手术的急性阑尾炎。我们在此报告一例发人深省的肺癌阑尾转移病例。
一名71岁男性被诊断为伴有多处转移的晚期肺癌并接受了化疗。一个月后，他患上急性阑尾炎，并迅速接受了腹腔镜阑尾切除术。手术中观察到阑尾肿胀且有积脓。组织学分析显示阑尾中有浸润性腺癌，浸润了黏膜层、黏膜下层和肌层。甲状腺转录因子1免疫染色阳性表明为肺腺癌的阑尾转移，而非原发性阑尾恶性肿瘤。术后过程顺利，患者的肺部内科医生在术后恢复了持续化疗。
尽管肺腺癌的阑尾转移罕见，但它常导致急性阑尾炎。应毫不犹豫地进行包括急诊手术在内的最佳治疗，以便尽快恢复化疗。
