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低级别阑尾黏液性肿瘤合并肠套叠。

Low-grade appendiceal mucinous tumor complicated by intussusception.

作者信息

Guo Chunzhi, Qu Yan, Liu Hong

机构信息

Department of Thyroid Surgery, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Hospital), Qingdao, Shandong, China.

General Surgery/Department of Gastrointestinal Surgery, The Second Affiliated Hospital of ZunYi Medical University, Zunyi, Guizhou, China.

出版信息

Medicine (Baltimore). 2025 Jun 6;104(23):e42540. doi: 10.1097/MD.0000000000042540.

Abstract

RATIONALE

Appendiceal mucinous tumors with intussusception are extremely rare. As primary lesions, malignant tumors often present with atypical clinical symptoms, which increases the likelihood of misdiagnosis.

PATIENT CONCERNS

A 79-year-old female patient of Miao ethnicity in Guizhou Province, China, was admitted with intermittent paroxysmal abdominal pain for 20 days and abdominal distension for 3 days.

DIAGNOSES

Computed tomography revealed ileal intussusception in the lower abdomen, suspected to be associated with a tumor.

INTERVENTIONS

Laparoscopy-assisted right hemicolectomy was performed.

OUTCOMES

Postoperative histopathology showed a low-grade appendiceal mucinous tumor with mucinous components extending into the muscularis propria and localized calcification. Regular follow-up was recommended.

LESSONS

Low-grade appendiceal mucinous tumors are extremely rare and are even less common when complicated by intussusception. Their clinical presentation is nonspecific, which may result in missed diagnosis. Therefore, thorough preoperative evaluation and careful surgical planning are essential for improving prognosis and minimizing the risk of severe complications.

摘要

理论依据

伴有肠套叠的阑尾黏液性肿瘤极为罕见。作为原发性病变,恶性肿瘤常表现出非典型临床症状,这增加了误诊的可能性。

患者情况

中国贵州省一名79岁苗族女性患者,因间歇性阵发性腹痛20天、腹胀3天入院。

诊断

计算机断层扫描显示下腹部回肠套叠,怀疑与肿瘤有关。

干预措施

实施腹腔镜辅助右半结肠切除术。

结果

术后组织病理学显示为低级别阑尾黏液性肿瘤,黏液成分延伸至固有肌层并伴有局部钙化。建议定期随访。

经验教训

低级别阑尾黏液性肿瘤极为罕见,并发肠套叠时更为少见。其临床表现不具特异性,可能导致漏诊。因此,全面的术前评估和精心的手术规划对于改善预后和降低严重并发症风险至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b760/12150915/e5c503a292c7/medi-104-e42540-g001.jpg

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