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转移性胃腺癌合并阑尾积脓:一例报告。

Metastatic gastric adenocarcinoma with appendiceal phlegmon: a case report.

机构信息

Clinical Research Development Unit of Shahid Beheshti Hospital, Hamadan University of Medical Science, Hamadan, Iran.

Clinical Research Development Unit of Besat Hospital, Hamadan University of Medical Science, Hamadan, Iran.

出版信息

J Med Case Rep. 2023 Feb 27;17(1):81. doi: 10.1186/s13256-023-03787-3.

Abstract

BACKGROUND

Gastric carcinoma is one of the most frequent malignancies worldwide. Gastric cancer metastasis to the appendix is uncommon in incidence, and has been rarely described in acute-appendicitis-related literature reviews. In this presented case, we have reported a rare case of appendiceal phlegmon, due to a diagnosis of metastatic gastric adenocarcinoma with uncommon symptoms.

CASE PRESENTATION

A 79-year-old Caucasian male presented to the emergency department with history of weakness, anorexia, lethargy, and mood changes for 2 months. Abdominopelvic computed tomography showed an abscess in right iliac muscle. After percutaneous drainage of the abscess and 6 weeks antibiotic therapy, an appendectomy was done for the patient. Histopathologic findings revealed the involvement of the appendiceal wall by adenocarcinoma, most probably with gastrointestinal origin. Gastric cancer was confirmed later by upper endoscopy and pathologic report.

CONCLUSIONS

Although the presence of tumor in appendectomy specimens is rare, and metastasis to appendix is even rarer, it should be considered as a cause of appendicitis, especially in elderly patients.

摘要

背景

胃癌是全球最常见的恶性肿瘤之一。胃癌转移至阑尾的发病率不高,在与急性阑尾炎相关的文献综述中也很少有描述。在本案例中,我们报告了一例罕见的阑尾积脓病例,该患者因转移性胃腺癌的罕见症状而被诊断。

病例介绍

一名 79 岁的白人男性因虚弱、食欲不振、嗜睡和情绪改变 2 个月而就诊于急诊科。腹部盆腔 CT 显示右侧髂腰肌脓肿。在脓肿经皮引流和 6 周抗生素治疗后,对患者进行了阑尾切除术。组织病理学检查显示阑尾壁被腺癌累及,最可能来源于胃肠道。后来通过胃镜检查和病理报告证实了胃癌的诊断。

结论

尽管阑尾切除标本中存在肿瘤的情况很少见,转移至阑尾的情况更为罕见,但应将其视为阑尾炎的病因之一,尤其是在老年患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/824d/9969687/b4758eb8b1ad/13256_2023_3787_Fig1_HTML.jpg

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