Fornaro R, Secco G B, Terrizzi A, Boaretto R, Fardelli R, Canaletti M, Baldi E, Pastorino A, Ferraris R
Cattedra di Semeiotica Chirurgica I, Università degli Studi di Genova.
G Chir. 1998 Apr;19(4):165-9.
The Authors underline the most important pathological, clinical and therapeutic aspects of appendiceal adenocarcinoid. Appendiceal adenocarcinoid is quite a rare tumor, presently considered as a single entity; it differs from typical carcinoid of the appendix because of its well definite histology, its aggressive behaviour and its poorer prognosis. There are no precise prognostic and therapeutic criteria to direct the operative choice between appendectomy and hemicolectomy. In particular the tumor diameter is of no use since the tumor often present diffuse rather than nodular growth. According to most Authors appendectomy is not sufficient in the following cases: liver lymph-node or retroperitoneal metastases; cecal meso-appendiceal or peritoneal spreading; histological poorly differentiated tumors, with nuclear atypia and high mitotic count. Some Authors performed hemicolectomy and bilateral oophorectomy in all case with peritoneal involvement since the ovaries are a frequent site of metastases.
作者强调了阑尾腺类癌最重要的病理、临床和治疗方面。阑尾腺类癌是一种相当罕见的肿瘤，目前被视为一个单独的实体；它与典型的阑尾类癌不同，因其组织学特征明确、行为侵袭性强且预后较差。目前尚无精确的预后和治疗标准来指导在阑尾切除术和半结肠切除术之间做出手术选择。特别是肿瘤直径并无参考价值，因为肿瘤常呈弥漫性生长而非结节状生长。大多数作者认为，在以下情况下单纯阑尾切除术是不够的：存在肝淋巴结或腹膜后转移；盲肠系膜 - 阑尾或腹膜播散；组织学上低分化肿瘤，伴有核异型性和高有丝分裂计数。一些作者对所有有腹膜受累的病例都进行了半结肠切除术和双侧卵巢切除术，因为卵巢是常见的转移部位。
