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源于尾肠囊肿的直肠后黏液腺癌:一例报告并文献复习

Retrorectal mucinous adenocarcinoma arising from a tailgut cyst: A case report and review of literature.

作者信息

Wang Yan-Shuai, Guo Qing-Yun, Zheng Fang-Hong, Huang Zi-Wei, Yan Jia-Lang, Fan Fu-Xiang, Liu Tian, Ji Shun-Xian, Zhao Xiao-Feng, Zheng Yi-Xiong

机构信息

Department of General Surgery, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu 322000, Zhejiang Province, China.

Department of Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, Zhejiang Province, China.

出版信息

World J Gastrointest Surg. 2022 Sep 27;14(9):1072-1081. doi: 10.4240/wjgs.v14.i9.1072.

Abstract

BACKGROUND

Tailgut cysts are defined as congenital cysts that develop in the rectosacral space from the residue of the primitive tail. As a congenital disease, caudal cysts are very rare, and their canceration is even rarer, which makes the disease prone to misdiagnosis and delayed treatment. We describe a case of caudal cyst with adenocarcinogenesis and summarize in detail the characteristics of cases with analytical value reported since 1990.

CASE SUMMARY

A 35-year-old woman found a mass in her lower abdomen 2 mo ago. She was asymptomatic at that time and was not treated because of the coronavirus disease 2019 pandemic. Two weeks ago, the patient developed abdominal distension and right waist discomfort and came to our hospital. Except for the high level of serum carcinoembryonic antigen, the medical history and laboratory tests were not remarkable. Magnetic resonance imaging showed a well-defined, slightly lobulated cystic-solid mass with a straight diameter of approximately 10 cm × 9 cm in the presacral space, slightly high signal intensity on T2-weighted imaging, and moderate signal intensity on T1-weighted imaging. The mass was completely removed by laparoscopic surgery. Histopathological examination showed that the lesion was an intestinal mucinous adenocarcinoma, and the multidisciplinary team decided to implement postoperative chemotherapy. The patient recovered well, the tumor marker levels returned to normal, and tumor-free survival has been achieved thus far.

CONCLUSION

The case and literature summary can help clinicians and researchers develop appropriate examination and therapeutic methods for diagnosis and treatment of this rare disease.

摘要

背景

尾肠囊肿被定义为在直肠骶骨间隙由原始尾残留发育而成的先天性囊肿。作为一种先天性疾病,尾囊肿非常罕见,其癌变更是罕见,这使得该疾病易于误诊和延误治疗。我们描述一例发生腺癌的尾囊肿病例,并详细总结自1990年以来报道的具有分析价值的病例特征。

病例摘要

一名35岁女性2个月前发现下腹部有一肿块。当时她无症状,因2019冠状病毒病大流行未接受治疗。两周前,患者出现腹胀和右腰不适,前来我院就诊。除血清癌胚抗原水平高外,病史和实验室检查无明显异常。磁共振成像显示在骶前间隙有一个边界清晰、略呈分叶状的囊实性肿块,直径约10 cm×9 cm,T2加权成像呈略高信号强度,T1加权成像呈中等信号强度。通过腹腔镜手术将肿块完全切除。组织病理学检查显示病变为肠黏液腺癌,多学科团队决定实施术后化疗。患者恢复良好,肿瘤标志物水平恢复正常,至今已实现无瘤生存。

结论

该病例及文献总结有助于临床医生和研究人员为诊断和治疗这种罕见疾病制定适当的检查和治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa55/9521465/465ff42c6325/WJGS-14-1072-g001.jpg

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