Amir Baraa, Amir Amaar, Sheikh Salwa
Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia.
Pathology Services, John Hopkins Aramco Healthcare, Dhahran 34455, Saudi Arabia.
J Surg Case Rep. 2023 Oct 17;2023(10):rjad567. doi: 10.1093/jscr/rjad567. eCollection 2023 Oct.
High-grade appendiceal mucinous neoplasms (HAMN) are rare mucinous appendiceal tumors that are mostly incidentally discovered and histologically show marked cytoplasmic atypia. We report a 62-year-old female patient who was diagnosed with acute right flank pain mimicking renal colic. Abdominal and pelvis CT scans showed no calculi or hydronephrosis. Incidentally, a markedly distended retrocecal appendix was identified and an appendectomy was performed. Histopathology revealed an HAMN of size 5.8 cm. HAMN are one of the rare and somewhat recently described epithelial appendiceal tumors. The latest 2019 classification is based on histologic appearance and on the consensus for classification and pathologic reporting of and associated appendiceal neoplasia (Peritoneal Surface Pathology Group International, modified Delphi process). Histologically, appendiceal mucinous lesions are classified as nonneoplastic/mucocele and neoplastic lesions with separate subcategorization. Despite its rarity, it is crucial for clinicians to be aware of HAMN to distinguish it from other clinical differentials.
高级别阑尾黏液性肿瘤（HAMN）是罕见的阑尾黏液性肿瘤，大多为偶然发现，组织学上表现为明显的细胞质异型性。我们报告一例62岁女性患者，诊断为酷似肾绞痛的急性右下腹疼痛。腹部和盆腔CT扫描未显示结石或肾积水。偶然发现一个明显扩张的盲肠后阑尾，并进行了阑尾切除术。组织病理学显示为大小5.8厘米的HAMN。HAMN是罕见且近期才有所描述的阑尾上皮性肿瘤之一。最新的2019年分类基于组织学表现以及国际腹膜表面病理组织（Peritoneal Surface Pathology Group International）对阑尾肿瘤及相关阑尾肿瘤的分类和病理报告的共识（改良德尔菲法）。组织学上，阑尾黏液性病变分为非肿瘤性/黏液囊肿和肿瘤性病变，并进一步细分。尽管HAMN罕见，但临床医生了解它以将其与其他临床鉴别诊断区分开来至关重要。
