Department of Surgery, Kyoto University Hospital, Kyoto, Japan.
Department of Surgery, Uji-Tokushukai Medical Center, Kyoto, Japan.
Asian J Endosc Surg. 2024 Oct;17(4):e13368. doi: 10.1111/ases.13368.
Low-grade appendiceal mucinous neoplasm (LAMN) is principally characterized by low-grade cytology without evidence of invasion to other organs. We report a LAMN surgical case whose appendiceal tumor penetrated the sigmoid colon wall. An 87-year-old man was referred for endoscopic resection (ER) of a colon polyp. Despite four ERs over 5 years, the polyp recurred at the same site. Laparoscopic surgery revealed a dilated appendix firmly attached to the sigmoid colon. We performed en bloc resection of both the sigmoid colon and appendix without tumor exposure. The histopathological evaluation showed that the LAMN had penetrated the sigmoid colon wall, forming two polyps on the colonic mucosa. In cases where the appendiceal-colonic fistula is suspected, en bloc resection of the appendix and colon wall should be considered.
低级别阑尾黏液性肿瘤（LAMN）的主要特征是低级别细胞学，没有侵犯其他器官的证据。我们报告了一例 LAMN 手术病例，其阑尾肿瘤穿透了乙状结肠壁。一名 87 岁男性因结肠息肉行内镜下切除术（ER）而就诊。尽管在 5 年内进行了 4 次 ER，但息肉仍在同一部位复发。腹腔镜检查显示阑尾扩张，与乙状结肠紧密相连。我们进行了乙状结肠和阑尾的整块切除，而没有暴露肿瘤。组织病理学评估显示，LAMN 已穿透乙状结肠壁，在结肠黏膜上形成两个息肉。在怀疑阑尾-结肠瘘的情况下，应考虑整块切除阑尾和结肠壁。
