Liu Qi, Jiao Jie, Yu Guanying, Guo Peiming, Li Chengzhen
School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China.
Department of Gastrointestinal Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, China.
Front Surg. 2024 Nov 21;11:1484812. doi: 10.3389/fsurg.2024.1484812. eCollection 2024.
Recurrence of low-grade appendiceal pseudomyxoma peritonei (PMP) with splenic invasion and parastomal hernia is exceptionally rare. We present a 47-year-old female with recurrent PMP, four years post-cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). She presented with abdominal distension, splenic invasion, and parastomal hernia. Imaging revealed extensive peritoneal and pelvic metastases, splenic lesions, and parastomal hernia. Intraoperative findings confirmed widespread pseudomyxoma, involving the spleen and diaphragm. She underwent CRS, splenectomy, tumor resection, adhesiolysis, partial colectomy, hernia repair, and diaphragmatic reconstruction, followed by intraoperative HIPEC. Despite postoperative complications, the patient recovered well with no recurrence over 20 months. This case underscores the challenges of managing recurrent PMP with splenic metastases and parastomal hernias, highlighting the importance of multidisciplinary collaboration and personalized therapeutic strategies.
低度阑尾黏液性腹膜假黏液瘤（PMP）复发并伴有脾脏侵犯和造口旁疝极为罕见。我们报告一例47岁女性，在进行细胞减灭术（CRS）和热灌注化疗（HIPEC）四年后出现复发性PMP。她表现为腹胀、脾脏侵犯和造口旁疝。影像学检查显示广泛的腹膜和盆腔转移、脾脏病变以及造口旁疝。术中发现证实存在广泛的假黏液瘤，累及脾脏和膈肌。她接受了CRS、脾切除术、肿瘤切除术、粘连松解术、部分结肠切除术、疝修补术和膈肌重建术，随后进行了术中HIPEC。尽管术后出现并发症，但患者恢复良好，20个月内未复发。该病例强调了处理伴有脾脏转移和造口旁疝的复发性PMP的挑战，突出了多学科协作和个性化治疗策略的重要性。
