Toshima Toshiaki, Inada Ryo, Sakamoto Shinya, Takeda Eri, Yoshioka Takahiro, Kumon Kento, Mimura Naoki, Takata Nobuo, Tabuchi Motoyasu, Oishi Kazuyuki, Sato Takuji, Sui Kenta, Okabayashi Takehiro, Ozaki Kazuhide, Nakamura Toshio, Shibuya Yuichi, Matsumoto Manabu, Iwata Jun
Department of Gastroenterological Surgery, Kochi Health Sciences Center, Kochi 781-8555, Japan.
Department of Diagnostic Pathology, Kochi Health Sciences Center, Kochi 781-8555, Japan.
World J Clin Cases. 2024 Aug 6;12(22):5217-5224. doi: 10.12998/wjcc.v12.i22.5217.
Goblet cell carcinoid (GCC) of the appendix is a rare tumor characterized by neuroendocrine and adenocarcinoma features. Accurate preoperative diagnosis is very difficult, with most patients complaining mainly of abdominal pain. Computed tomography shows swelling of the appendix, so diagnosis is usually made incidentally after appendectomy based on a preoperative diagnosis of appendicitis. Even if a patient undergoes preoperative colonoscopy, accurate endoscopic diagnosis is very difficult because GCC shows a submucosal growth pattern with invasion of the appendiceal wall.
Between 2017 and 2022, 6 patients with GCC were treated in our hospital. The presenting complaint for 5 of these 6 patients was abdominal pain. All 5 patients underwent appendectomy, including 4 for a preoperative diagnosis of appendicitis and the other for diagnosis and treatment of an appendiceal tumor. The sixth patient presented with vomiting and underwent ileocecal resection for GCC diagnosed from preoperative biopsy. Although 2 patients with GCC underwent colonoscopy, no neoplastic changes were identified. Two of the six patients showed lymph node metastasis on pathological examination. As of the last follow-up (median: 15 mo), all cases remained alive without recurrence.
As preoperative diagnosis of GCC is difficult, this possibility must be considered during surgical treatments for presumptive appendicitis.
阑尾杯状细胞类癌（GCC）是一种罕见肿瘤，具有神经内分泌和腺癌特征。术前准确诊断非常困难，大多数患者主要诉说腹痛。计算机断层扫描显示阑尾肿胀，因此通常在阑尾切除术后，根据术前阑尾炎诊断偶然做出诊断。即使患者接受术前结肠镜检查，准确的内镜诊断也非常困难，因为GCC呈黏膜下生长模式并侵犯阑尾壁。
2017年至2022年期间，我院治疗了6例GCC患者。这6例患者中有5例的主诉是腹痛。这5例患者均接受了阑尾切除术，其中4例术前诊断为阑尾炎，另1例用于阑尾肿瘤的诊断和治疗。第6例患者表现为呕吐，因术前活检诊断为GCC而接受了回盲部切除术。虽然2例GCC患者接受了结肠镜检查，但未发现肿瘤性改变。6例患者中有2例在病理检查时显示有淋巴结转移。截至最后一次随访（中位时间：15个月），所有病例均存活且无复发。
由于GCC术前诊断困难，在对疑似阑尾炎进行手术治疗时必须考虑到这种可能性。
