Meza-Martinez Daniel A, Suro Santos Yeudiel, Andrade-Ordoñez Samantha J, Palomino-Payan Julio A, Fematt-Rodriguez Brando J
General Surgery, Instituto Mexicano del Seguro Social, Hospital General de Zona No. 33, Monterrey, MEX.
Cureus. 2024 Jul 23;16(7):e65168. doi: 10.7759/cureus.65168. eCollection 2024 Jul.
Appendiceal mucinous neoplasms may present without symptoms or with chronic pain in the right lower quadrant. This report describes a case of a 35-year-old woman who presented with chronic right lower quadrant pain and was found to have a low-grade appendiceal mucinous neoplasm (LAMN). Physical examination revealed localized tenderness in the right lower quadrant with no additional symptoms. Preoperative laboratory results were normal, and a CT scan revealed a cystic appendiceal lesion with an internal calcification, initially mistaken for a fecalith, which led to the decision for exploratory laparotomy. Intraoperative findings confirmed the presence of a cystic-like appendiceal lesion, and an open appendectomy was performed. Histopathological examination revealed a low-grade appendiceal mucinous neoplasm (LAMN) confined to the mucosa, without evidence of metastatic disease. The patient had an uneventful recovery and required no additional treatment. This case highlights that surgical intervention with proper technique for confined appendiceal neoplasms, combined with effective preoperative imaging and thorough histopathological examination, is crucial for diagnosis and effective management, ensuring favorable outcomes.
阑尾黏液性肿瘤可能无症状，或表现为右下腹慢性疼痛。本报告描述了一例35岁女性病例，该患者因右下腹慢性疼痛就诊，被发现患有低级别阑尾黏液性肿瘤（LAMN）。体格检查发现右下腹有局部压痛，无其他症状。术前实验室检查结果正常，CT扫描显示阑尾有一个伴有内部钙化的囊性病变，最初被误诊为粪石，因此决定进行剖腹探查术。术中发现证实存在一个囊性阑尾样病变，并进行了开放性阑尾切除术。组织病理学检查显示为局限于黏膜的低级别阑尾黏液性肿瘤（LAMN），无转移疾病证据。患者恢复顺利，无需额外治疗。该病例强调，对于局限于阑尾的肿瘤，采用适当技术进行手术干预，结合有效的术前影像学检查和全面的组织病理学检查，对于诊断和有效管理至关重要，可确保良好的治疗效果。
