Liu Dong, Xing Yue-Long, Chen Dan
Department of Hepatobiliary and Pancreatic Gastroenterology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People's Hospital, Jinhua 321000, Zhejiang Province, China.
Department of Gastroenterology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People's Hospital, Jinhua 321000, Zhejiang Province, China.
World J Gastrointest Oncol. 2025 May 15;17(5):104011. doi: 10.4251/wjgo.v17.i5.104011.
Low-grade appendiceal mucinous neoplasms (LAMNs) are a class of histologically well-differentiated adenomas that can proliferate outside the appendix in the form of malignant tumours, resulting in the accumulation of external appendiceal mucus. They may present as an extra-appendiceal mass-like bulge, mucus or polypoid tissue at the appendiceal orifice, or even with abdominal dissemination. The surgical approach is usually appendectomy, ileocecal resection or right hemicolectomy. It is essential to raise awareness of LAMNs and choose an appropriate treatment.
A 68-year-old man underwent a routine physical examination at our hospital on May 17, 2022. The patient had no symptoms of abdominal pain, bloating, or weight loss, and his tumour marker levels were normal. The faecal occult blood test was negative, and no abnormalities were identified on physical examination. Colonoscopy revealed a submucosal protrusion at the appendiceal orifice. During endoscopic ultrasound, uneven echoes were observed in the appendix cavity. A contrast-enhanced computed tomography scan of the abdomen revealed a nodular thickening at the base of the appendix, with a diameter of approximately 1 cm. When all the examination results were considered, we suspected the lesion to be an appendiceal mucinous tumour. Laparoscopic surgery was performed using the double purse-string suture method. Postoperative pathology suggested a low-grade mucinous cystadenoma of the appendix with no involvement of the margins. A repeat colonoscopy 18 months after surgery revealed no significant abnormality at the appendiceal orifice. A contrast-enhanced computed tomography scan of the abdomen suggested only postoperative changes.
This study describes a case of LAMN that was treated by resecting the mass at the appendiceal orifice the double purse-string suture technique and provides new insights on the diagnosis and treatment of LAMNs.
低度阑尾黏液性肿瘤（LAMNs）是一类组织学上分化良好的腺瘤，可呈恶性肿瘤形式在阑尾外增殖，导致阑尾外黏液蓄积。它们可能表现为阑尾外肿块样隆起、阑尾开口处的黏液或息肉样组织，甚至伴有腹腔播散。手术方式通常为阑尾切除术、回盲部切除术或右半结肠切除术。提高对LAMNs的认识并选择合适的治疗方法至关重要。
一名68岁男性于2022年5月17日在我院接受常规体检。患者无腹痛、腹胀或体重减轻症状，肿瘤标志物水平正常。粪便潜血试验阴性，体格检查未发现异常。结肠镜检查发现阑尾开口处有黏膜下隆起。内镜超声检查时，阑尾腔内观察到回声不均匀。腹部增强计算机断层扫描显示阑尾根部有结节状增厚，直径约1 cm。综合所有检查结果，我们怀疑该病变为阑尾黏液性肿瘤。采用双荷包缝合法进行腹腔镜手术。术后病理提示阑尾低度黏液性囊腺瘤，切缘未受累。术后18个月复查结肠镜检查，阑尾开口处无明显异常。腹部增强计算机断层扫描仅提示术后改变。
本研究描述了一例通过双荷包缝合法切除阑尾开口处肿块治疗LAMN的病例，并为LAMNs的诊断和治疗提供了新的见解。
