Lee Sungchul, Kim Euitae, Park Dong-Guk
Department of Surgery, Dankook University College of Medicine, Cheonan, Korea.
Ann Coloproctol. 2024 May;40(Suppl 1):S18-S22. doi: 10.3393/ac.2022.00339.0048. Epub 2022 Nov 21.
A 61-year-old man presented with abdominal distension without any symptoms. On colonoscopy and computed tomography findings, it was clinically diagnosed as peritoneal metastasis of sigmoid colon cancer, and diagnostic laparoscopy was performed. Only the peritoneum was partially resected, and the pathology was signet ring cell carcinoma with predominantly local mucinous carcinoma component. However, the patient complained of persistent symptoms and, despite the progress of chemotherapy, the peritoneal dissemination worsened, and additional cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) was performed. Mixed adenoneuroendocrine carcinomas (MANECs) were reported in the appendix with perforated visceral peritoneum. After additional chemotherapy, the patient was discharged. Patients with advanced MANEC with peritoneal spreading may benefit from aggressive treatment by cytoreduction surgery with HIPEC, followed by intravenous chemotherapy.
一名61岁男性因腹胀就诊，无任何症状。根据结肠镜检查和计算机断层扫描结果，临床诊断为乙状结肠癌腹膜转移，并进行了诊断性腹腔镜检查。仅对部分腹膜进行了切除，病理结果为印戒细胞癌，主要为局部黏液癌成分。然而，患者仍有持续症状，尽管化疗进展，但腹膜播散仍恶化，遂进行了额外的细胞减灭术联合腹腔内热灌注化疗（HIPEC）。阑尾合并内脏腹膜穿孔处报告有混合性腺神经内分泌癌（MANEC）。经过额外化疗后，患者出院。晚期MANEC伴腹膜播散的患者可能受益于细胞减灭术联合HIPEC的积极治疗，随后进行静脉化疗。
