AlAli Mohammed N, Alnajjar Jawad S, Essa Mohamed S, Alrasheed Arwa F, AlAmodi Maha, Alromaih Nouf A, Amer Sadiq M, Al-Shoaibi Abdulbaset, Alshehri Ameen M
Department of Surgery, Prince Mohammed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia.
College of Medicine, King Faisal University, Alahsa, Saudi Arabia.
J Surg Case Rep. 2025 Apr 12;2025(4):rjaf214. doi: 10.1093/jscr/rjaf214. eCollection 2025 Apr.
Appendiceal mucinous neoplasms, including low-grade appendiceal mucinous neoplasms (LAMNs), are infrequent but clinically relevant due to their potential progression to pseudomyxoma peritonei. Timely diagnosis and surgical intervention are critical to preventing complications. We present a case series of three middle-aged men with LAMNs, each of whom exhibited right lower quadrant abdominal pain as their primary symptom. Diagnostic imaging in each case revealed features consistent with appendiceal mucoceles. Pathological findings confirmed LAMN, with varying extents of disease. One patient underwent an open appendectomy for LAMN confined to the appendix, while two required right hemicolectomy due to perforation and extra-appendiceal mucin involvement. LAMNs can be managed effectively through early detection and surgical resection. Complete resection with negative margins results in favorable outcomes and low recurrence rates. More aggressive treatments, including cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy, are necessary in cases with peritoneal involvement.
阑尾黏液性肿瘤，包括低级别阑尾黏液性肿瘤（LAMNs），虽然不常见，但因其有进展为腹膜假黏液瘤的潜在可能，所以具有临床相关性。及时诊断和手术干预对于预防并发症至关重要。我们报告了一组三例患有LAMNs的中年男性病例系列，他们均以右下腹痛为主要症状。每例的诊断性影像学检查均显示出与阑尾黏液囊肿相符的特征。病理结果证实为LAMN，疾病程度各异。一名患者因LAMN局限于阑尾而接受了开放性阑尾切除术，而另外两名患者因穿孔和阑尾外黏液累及而需要进行右半结肠切除术。LAMNs可通过早期检测和手术切除得到有效治疗。切缘阴性的完整切除可带来良好的预后和低复发率。对于有腹膜受累的病例，需要更积极的治疗，包括进行或不进行热灌注化疗的细胞减灭术。
