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尾肠囊肿伴腺癌转化:一例罕见病例报告

Tailgut cyst with adenocarcinoma transition: A rare case report.

作者信息

Wang Min, Liu Guoliang, Mu Yu, He Hongyu, Wang Shuang, Li Jiannan

机构信息

Department of General Surgery.

Operating Theater and Department of Anesthesiology.

出版信息

Medicine (Baltimore). 2020 Jul 2;99(27):e20941. doi: 10.1097/MD.0000000000020941.

Abstract

RATIONALE

Tailgut cyst (TGC) is a rare congenital disease that originates from residues of the tail intestine during the embryonic period. Most TGCs are benign lesions and the malignant transition is very rare.

PATIENT CONCERNS

A 50-year-old woman attended our department complaining of defecation difficulty for more than 2 months. She reported irregular defecation with a small amount of liquid stool, 3 to 4 times per day.

DIAGNOSIS

Biochemical analysis showed high levels of carcinoembryonic antigen (79.89 ng/mL; normal, 0-3 ng/mL) and carbohydrate antigen 199 (57.60 U/mL; normal, 0-35 U/mL). Abdominal computer tomography and magnetic resonance imaging showed a large cystic mass with enhanced signals. Post-surgical histopathology indicated that the mass was a TGC with adenocarcinoma transition.

INTERVENTIONS

The cyst was completely resected. Symptomatic treatment was further performed, and the patient recovered well.

LESSONS

We reported a rare case of a large TGC with adenocarcinoma transition. CT, MRI, and histopathology are important to diagnose TGC. Complete surgical resection is the first choice to treat TGC.

摘要

理论依据

尾肠囊肿(TGC)是一种罕见的先天性疾病,起源于胚胎期尾肠的残留物。大多数TGC是良性病变,恶变非常罕见。

患者情况

一名50岁女性因排便困难2个多月前来我院就诊。她报告排便不规律,每天有少量稀便3至4次。

诊断

生化分析显示癌胚抗原水平升高(79.89 ng/mL;正常范围0 - 3 ng/mL)和糖类抗原199升高(57.60 U/mL;正常范围0 - 35 U/mL)。腹部计算机断层扫描和磁共振成像显示一个大的囊性肿块,信号增强。术后组织病理学表明该肿块是一个发生腺癌转变的TGC。

干预措施

囊肿被完全切除。进一步进行了对症治疗,患者恢复良好。

经验教训

我们报告了一例罕见的发生腺癌转变的巨大TGC病例。CT、MRI和组织病理学对诊断TGC很重要。完整的手术切除是治疗TGC的首选方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9f8/7337533/176465327217/medi-99-e20941-g001.jpg

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