Ma Xuhui, Dong Wei, Yang Qing, Yu Jie, Zhou Shunchang, Zhong Yuxu, Chu Haibo
Department of General Surgery, Jiaozhou Branch of Shanghai East Hospital, Tongji University, Qingdao, Shandong, P.R. China.
Department of Pathology, Jiaozhou Branch of Shanghai East Hospital, Tongji University, Qingdao, Shandong, P.R. China.
Medicine (Baltimore). 2025 Jun 6;104(23):e42828. doi: 10.1097/MD.0000000000042828.
Low-grade appendiceal mucinous neoplasm (LAMN) is a rare subtype of appendiceal pathology characterized by epithelial hyperplasia, cellular atypia, and mucinous accumulation within the appendiceal lumen, leading to obstructive expansion of the organ. Representing a mere 0.2% to 0.3% of all appendectomies and approximately 0.5% of gastrointestinal tumors, LAMN poses diagnostic challenges in surgical practice.
We conducted a retrospective analysis of a patient with the appendiceal neoplasm. A 39-year-old female presented to Jiaozhou Hospital, East Hospital Affiliated to Tongji University on July 9, 2022, complaining of a nine-day history of right lower abdominal pain, distension, and nausea. Physical examination revealed a palpable measuring 15 × 6 cm in the right lower quadrant, accompanied by tenderness, rebound tenderness, and muscular guarding.
Histopathological examination confirmed the diagnosis of a LAMN without evidence of lymphovascular invasion, serosal, or mesenteric infiltration.
After antiinflammatory therapy and comprehensive assessment, the neoplasm was excised through three-dimensional laparoscopic surgery.
No recurrence was observed during an 32-month postoperative follow-up period.
Despite its rarity, LAMN warrants clinical attention due to its nonspecific symptoms. Computed tomography scans significantly improve preoperative diagnostic accuracy, with pathological diagnosis serving as the gold standard. Surgical intervention is the preferred treatment option, albeit controversies persist regarding surgical extent and the utilization of preoperative and postoperative chemotherapy.
低级别阑尾黏液性肿瘤（LAMN）是阑尾病理学中一种罕见的亚型，其特征为上皮增生、细胞异型性以及阑尾腔内黏液积聚，导致器官梗阻性扩张。LAMN仅占所有阑尾切除术的0.2%至0.3%，约占胃肠道肿瘤的0.5%，在外科实践中带来了诊断挑战。
我们对一名患有阑尾肿瘤的患者进行了回顾性分析。一名39岁女性于2022年7月9日就诊于同济大学附属东方医院胶州医院，主诉右下腹痛、腹胀及恶心9天。体格检查发现右下腹可触及一个大小为15×6厘米的肿物，伴有压痛、反跳痛及肌紧张。
组织病理学检查确诊为LAMN，无淋巴管侵犯、浆膜或肠系膜浸润证据。
经抗炎治疗及综合评估后，通过三维腹腔镜手术切除肿瘤。
术后32个月随访期间未观察到复发。
尽管LAMN罕见，但因其症状不具特异性，仍需临床关注。计算机断层扫描显著提高了术前诊断准确性，病理诊断为金标准。手术干预是首选治疗方案，不过在手术范围以及术前和术后化疗的应用方面仍存在争议。
