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伪装成上皮性交界性卵巢肿瘤的阑尾黏液囊肿:来自索马里的一例病例报告

Appendiceal mucocele masquerading as an epithelial borderline ovarian tumor: A case report from Somalia.

作者信息

Muse Nuur Mucaawiye, Said Abdirahman Ibrahim, Mohamed Ismail, Hussein Abdilahi, Hussein Mohamed Omer, Elmi Hassan Sh Abdirahman

机构信息

College of Health Science, School of Medicine, Amoud University, Borama, Somalia; Department of Surgery, Borama Regional Hospital, Borama, Somalia.

College of Health Science, School of Medicine, Amoud University, Borama, Somalia.

出版信息

Int J Surg Case Rep. 2024 Dec;125:110658. doi: 10.1016/j.ijscr.2024.110658. Epub 2024 Nov 24.

Abstract

INTRODUCTION

Appendiceal mucocele, a rare condition characterized by mucoid material accumulation in the appendix, often presents asymptomatically. Diagnosis can be challenging, and surgical resection is crucial to prevent complications. We report a case managed in a low-resource setting, highlighting the importance of early identification.

CASE PRESENTATION

A 56-year-old postmenopausal woman presented with right lower quadrant pain and a pelvic mass. Imaging revealed a cystic lesion and exploratory laparotomy was performed. Intraoperatively, a mucocele of the appendix was discovered. An appendectomy was performed, and a histopathological examination confirmed a serous borderline tumor, this work has been reported in line with the SCARE criteria.

DISCUSSION

Preoperative diagnosis of appendiceal mucoceles is difficult due to their clinical variability. Surgical intervention is essential, with meticulous resection required to prevent peritoneal contamination. The absence of intraoperative pathology consultation in this case underscores the need for greater access to specialized resources, including pathology services, in resource-limited settings to ensure accurate diagnosis and appropriate surgical management.

CONCLUSION

This case highlights the critical importance of clinical suspicion for appendiceal mucoceles, even when initial radiological findings are inconclusive. The lack of intraoperative pathology consultation underscores the need for specialized pathology services in resource-limited settings. Given the increased risk of colonic adenocarcinoma, multidisciplinary collaboration and diligent post-operative surveillance are crucial for optimizing patient outcomes.

摘要

引言

阑尾黏液囊肿是一种罕见疾病,其特征为阑尾内黏液物质积聚,通常无症状。诊断可能具有挑战性,手术切除对于预防并发症至关重要。我们报告一例在资源有限环境下处理的病例,强调早期识别的重要性。

病例介绍

一名56岁绝经后女性出现右下腹疼痛和盆腔肿块。影像学检查显示为囊性病变,遂进行了剖腹探查术。术中发现阑尾黏液囊肿。进行了阑尾切除术,组织病理学检查证实为浆液性交界性肿瘤,本病例已按照SCARE标准报告。

讨论

由于阑尾黏液囊肿临床表现多样,术前诊断困难。手术干预至关重要,需要细致切除以防止腹腔污染。本病例术中未进行病理会诊,凸显了在资源有限环境中更广泛获取包括病理服务在内的专业资源以确保准确诊断和适当手术管理的必要性。

结论

本病例强调了即使初始影像学检查结果不明确,对阑尾黏液囊肿进行临床怀疑的至关重要性。术中缺乏病理会诊凸显了资源有限环境中对专业病理服务的需求。鉴于结肠腺癌风险增加,多学科协作和术后密切监测对于优化患者预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f44/11629187/29f1612a7766/gr1.jpg

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