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多发性肠血管瘤伴低级别阑尾黏液性肿瘤引起肠套叠 1 例报告及文献复习。

Multiple intestinal hemangioma concurrent with low-grade appendiceal mucinous neoplasm presenting as intussusception-a case report and literature review.

机构信息

Department of Pathology, Qingdao Municipal Hospital, Qingdao, 266071, China.

出版信息

World J Surg Oncol. 2022 Feb 23;20(1):44. doi: 10.1186/s12957-022-02519-z.

Abstract

BACKGROUND

Cases with intussusception caused by either intestinal hemangiomas or appendiceal mucinous neoplasms are extremely rare.

CASE PRESENTATION

In this study, we reported a 47-year-old male presented with paroxysmal abdominal pain and postprandial bloating for 3 days. CT results indicated a high possibility of secondary intussusception in ascending colon. Histopathology indicated a mixed type of cavernous and capillary hemangioma, combined with low-grade appendiceal mucinous neoplasms (LAMNs) and intestinal obstruction. The patient underwent laparotomy and right hemicolectomy. Finally, the patient was followed up for 4 months with no disease progression.

CONCLUSIONS

Rare studies reported the intestine hemangiomas coincided with appendix low-grade mucinous tumor. Its manifestations are not specific, which is a challenge in the preoperative diagnosis. For cases with intussusception that was not observed in time, it may lead to intestinal necrosis and diffuse peritonitis. Additionally, the ruptured mucinous tumor in the appendix may lead to pathogenesis of pseudomyxoma peritonei. Therefore, accurate diagnosis and appropriate surgery-based treatment contribute to the improvement of prognosis and severe outcomes among these patients.

摘要

背景

由肠血管瘤或阑尾黏液性肿瘤引起的肠套叠病例极为罕见。

病例介绍

本研究报道了 1 例 47 岁男性,因阵发性腹痛和餐后腹胀 3 天就诊。CT 结果提示升结肠继发性肠套叠的可能性较大。组织病理学提示为海绵状和毛细血管混合血管瘤,伴有低级别阑尾黏液性肿瘤(LAMN)和肠梗阻。患者接受了剖腹手术和右半结肠切除术。最终,患者随访 4 个月,无疾病进展。

结论

罕见的研究报道了肠血管瘤合并阑尾低级别黏液肿瘤。其表现不具特异性,这对术前诊断构成挑战。对于未及时发现的肠套叠病例,可能导致肠坏死和弥漫性腹膜炎。此外,阑尾破裂的黏液性肿瘤可能导致假性黏液瘤病的发病机制。因此,准确的诊断和基于手术的适当治疗有助于改善这些患者的预后和严重后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec7e/8864818/9bf73b1e8ed1/12957_2022_2519_Fig1_HTML.jpg

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