Center for Perioperative Optimization, Department of Surgery, Herlev and Gentofte Hospitals, University of Copenhagen, Herlev, DK-2730, Denmark.
F1000Res. 2021 Feb 26;10:152. doi: 10.12688/f1000research.50909.2. eCollection 2021.
Appendiceal cancer is rare and is often diagnosed incidentally in patients undergoing appendectomy for acute appendicitis. However, patients with appendiceal cancer are at increased risk of synchronous malignancy. In this case report, we present a 58-year-old man initially diagnosed with acute appendicitis after presenting to the emergency department with abdominal pain. He had an appendectomy and was discharged the following day. Unexpectedly, the postoperative histopathologic examination showed a primary adenocarcinoma in the appendix. A computed tomography scan showed rectal wall thickening and the patient was referred to colonoscopy where an experienced endoscopist found a rectal tumor during the digital rectal examination prior to the colonoscopy. The tumor was initially missed by the newly qualified doctor who examined the patient during his first admittance to hospital. The patient's two primary cancers were treated with a laparoscopic right hemicolectomy for the appendiceal cancer and a low anterior resection for the rectal cancer. This case supports the importance of a full colorectal workup in patients with appendiceal cancer. It also emphasizes the value of a thorough digital rectal examination and the need for improved focus on teaching and practice of the procedure.
阑尾腺癌较为罕见，通常在因急性阑尾炎而行阑尾切除术的患者中偶然诊断。然而，阑尾腺癌患者存在同步恶性肿瘤的风险增加。在本病例报告中，我们介绍了一位 58 岁男性，他因腹痛就诊于急诊科，最初被诊断为急性阑尾炎。他接受了阑尾切除术，并于次日出院。出乎意料的是，术后组织病理学检查显示阑尾原发性腺癌。腹部 CT 扫描显示直肠壁增厚，患者被转介至结肠镜检查，一位经验丰富的内镜医生在结肠镜检查前的直肠指诊中发现了直肠肿瘤。该肿瘤最初被一位新入职的医生漏诊，该医生在患者首次入院时对其进行了检查。该患者的两个原发性肿瘤分别通过腹腔镜右半结肠切除术和直肠低位前切除术进行治疗。该病例支持对阑尾腺癌患者进行全面结直肠检查的重要性。它还强调了直肠指诊的价值，需要更加注重该操作的教学和实践。
