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克罗恩病患者回盲部切除术后偶然发现的低级别阑尾黏液性肿瘤:一例报告

Incidental low-grade appendiceal mucinous neoplasm in Crohn's disease patient post ileocecal resection: a case report.

作者信息

Aldakhil Mohammed Dakhel, Alowayyid Jawaher A, Alzunidi Mashel A, Albarrak Raghad Ibrahim

机构信息

Department of General Surgery, College of Medicine, Qassim University, Buraydah 52346, Saudi Arabia.

Department of General Surgery, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia.

出版信息

J Surg Case Rep. 2025 May 12;2025(5):rjaf294. doi: 10.1093/jscr/rjaf294. eCollection 2025 May.

Abstract

Appendiceal mucinous neoplasm is a rare tumor, found in 0.2%-0.3% of appendectomies. Inflammatory bowel disease (IBD) is a known risk factor for colorectal cancer; however, appendiceal mucinous neoplasm is rarely reported in IBD patients. Here we report a rare case in a patient with Crohn's disease after ileocecal resection. She complained of recurrent, severe right lower quadrant pain. Further investigation revealed stenosis at the terminal ileum with a clear appendiceal orifice on magnetic resonance enterography and colonoscopy. She was referred for surgical evaluation after failure of medical management. The diagnosis of low-grade appendiceal mucinous neoplasm was confirmed by pathology after an uneventful laparoscopic ileocecal resection. Although this tumor is rare in IBD patients, a high index of suspicion is needed in those presenting with disease flare-ups, and pathological examination remains essential for diagnosis. This case underscores the diagnostic challenges and clearly highlights the importance of thorough evaluation.

摘要

阑尾黏液性肿瘤是一种罕见肿瘤,在阑尾切除术患者中占0.2%-0.3%。炎症性肠病(IBD)是结直肠癌的已知危险因素;然而,IBD患者中阑尾黏液性肿瘤的报道很少。在此,我们报告1例克罗恩病患者回盲部切除术后发生阑尾黏液性肿瘤的罕见病例。患者反复出现严重的右下腹疼痛。进一步检查发现,磁共振小肠造影和结肠镜检查显示回肠末端狭窄,阑尾开口清晰可见。药物治疗失败后,患者接受了手术评估。在顺利完成腹腔镜回盲部切除术后,病理检查确诊为低级别阑尾黏液性肿瘤。尽管该肿瘤在IBD患者中罕见,但对于出现病情复发的患者仍需高度怀疑,病理检查仍是诊断的关键。该病例强调了诊断方面的挑战,并清楚地凸显了全面评估的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b9c/12066405/8b9664a30e94/rjaf294f1.jpg

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