Basukala Sunil, Bhusal Ujwal, Sharma Shriya, Tamang Ayush, Gurung Suman
Department of Surgery, Shree Birendra Hospital (SBH), Kathmandu, Nepal.
College of Medicine, Nepalese Army Institute of Health Sciences (NAIHS), Kathmandu, Nepal.
Int J Surg Case Rep. 2021 Dec;89:106625. doi: 10.1016/j.ijscr.2021.106625. Epub 2021 Nov 23.
Appendiceal neuroendocrine tumors (ANETs) are incidentally found in 0.2-0.7% of appendectomies for suspected appendicitis.
A 29-year-old female presented with pain in the right lower quadrant of her abdomen for the past 48 h. On emergency appendectomy for suspected acute appendicitis, a perforated appendix was found. Histopathological examination showed grade 1 (low) ANET.
Appendiceal neuroendocrine neoplasms (ANENs) are commonly found at the tip of the appendix and are treated with appendectomy alone. For few ANENs located at the base, or small tumors (≤2 cm) infiltrating the submucosa, the muscularis, the subserosa layer or the mesoappendix, right hemicolectomy is recommended. However, no guidelines have been established concerning patients with appendiceal perforation in case of ANENs.
Although rare, ANETs should be considered in the differential diagnosis of acute appendicitis. Since, ANETs are rarely diagnosed preoperatively, subsequent patient evaluation after appendectomy is crucial for management of the patient.
在因疑似阑尾炎而进行的阑尾切除术中，阑尾神经内分泌肿瘤（ANETs）的偶然发现率为0.2%-0.7%。
一名29岁女性在过去48小时内出现右下腹疼痛。在因疑似急性阑尾炎进行急诊阑尾切除术中，发现阑尾穿孔。组织病理学检查显示为1级（低级别）ANET。
阑尾神经内分泌肿瘤（ANENs）常见于阑尾尖端，通常仅通过阑尾切除术治疗。对于少数位于阑尾根部的ANENs，或浸润黏膜下层、肌层、浆膜下层或阑尾系膜的小肿瘤（≤2 cm），建议行右半结肠切除术。然而，对于ANENs合并阑尾穿孔的患者，尚未制定相关指南。
尽管罕见，但在急性阑尾炎的鉴别诊断中应考虑ANETs。由于ANETs术前很少被诊断出来，因此阑尾切除术后对患者的后续评估对于患者的管理至关重要。
