Department of Gynecology, Kanagawa Cancer Center, Kanagawa, Japan.
Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan.
J Obstet Gynaecol Res. 2023 Dec;49(12):2975-2978. doi: 10.1111/jog.15802. Epub 2023 Sep 28.
Low-grade appendiceal mucinous neoplasm (LAMN) is a rare epithelial malignancy of the appendix. If it perforates the abdominal cavity, it can cause a serious clinical syndrome called pseudomyxoma peritonei. In the present case, we laparoscopically removed a LAMN encountered during risk-reducing salpingo-oophorectomy (RRSO). The patient was a 53-year-old woman who was diagnosed with hereditary breast and ovarian cancer syndrome. RRSO was planned, and magnetic resonance imaging revealed a large cystic tumor in the right lower abdomen. We expected an ovarian cyst; however, it was a primary tumor of the appendix. Partial cecal resection was performed laparoscopically by a surgical oncologist. The pathological diagnosis was LAMN. Gynecologists may encounter this disease incidentally. Mucinous appendiceal neoplasm (MAN) may be encountered during RRSO. If a right lower abdominal mass is found near a normal ovary preoperatively, gynecologists should consider MAN as well as paraovarian cyst.
低级别阑尾黏液性肿瘤(LAMN)是阑尾罕见的上皮恶性肿瘤。如果它穿透腹腔,可能会导致一种称为腹膜假黏液瘤的严重临床综合征。在本病例中,我们通过腹腔镜切除了在 RRSO 期间遇到的 LAMN。患者为 53 岁女性,诊断为遗传性乳腺癌和卵巢癌综合征。计划 RRSO,磁共振成像显示右下腹部有一个大的囊性肿瘤。我们预计是卵巢囊肿;但实际上它是阑尾的原发性肿瘤。外科肿瘤学家通过腹腔镜进行了部分盲肠切除术。病理诊断为 LAMN。妇科医生可能会偶然遇到这种疾病。在 RRSO 期间可能会遇到黏液性阑尾肿瘤(MAN)。如果术前在正常卵巢附近发现右下腹部肿块,妇科医生应考虑 MAN 以及副卵巢囊肿。
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