Hillock Tyson, Smith James P
Surgery, Edward Via College of Osteopathic Medicine, Monroe, USA.
General Surgery, St. Francis Hospital, Monroe, USA.
Cureus. 2024 Aug 20;16(8):e67313. doi: 10.7759/cureus.67313. eCollection 2024 Aug.
Low-grade appendiceal mucinous neoplasms (LAMN) constitute a rare subset of epithelial tumors and represent the second most common form of appendiceal cancer. LAMN typically presents as acute appendicitis, with definitive diagnosis often occurring incidentally during appendectomy surgery. While contrast-enhanced computed tomography (CECT) is the imaging of choice, misdiagnoses are common, highlighting the need for additional diagnostic modalities that are often underutilized. There is ongoing debate about treatment recommendations which typically involve a simple appendectomy, but controversy persists regarding the intraoperative necessity of a cecectomy, ileocecectomy, or formal right hemicolectomy. Here, we present a case featuring a 72-year-old African American female referred to our surgery clinic presenting solely with bloating and constipation rather than classical acute appendicitis, discrepancies between CT and MR imaging, and an unusual intraoperative finding of a posteriorly positioned mucocele adhered to the cecum, necessitating right hemicolectomy.
低级别阑尾黏液性肿瘤（LAMN）是上皮性肿瘤中罕见的一类，是阑尾癌的第二常见形式。LAMN通常表现为急性阑尾炎，确诊往往在阑尾切除术中偶然发现。虽然增强计算机断层扫描（CECT）是首选的影像学检查，但误诊很常见，这凸显了对其他常用不足的诊断方法的需求。关于治疗建议存在持续的争论，通常包括单纯阑尾切除术，但对于术中是否需要进行盲肠切除术、回盲肠切除术或正规右半结肠切除术仍存在争议。在此，我们报告一例病例，一名72岁非裔美国女性转诊至我们的外科诊所，仅表现为腹胀和便秘，而非典型的急性阑尾炎，CT和磁共振成像（MR）存在差异，术中发现一个位于后方的黏液囊肿附着于盲肠，需要进行右半结肠切除术。
