虫垂周囲膿瘍を合併した原発性虫垂癌の1例 PRIMARY COLONIC CANCER OF THE APPENDIX ASSOCIATED WITH ABSCESS : A CASE REPORT

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原発性虫垂癌は稀な疾患で,術前に診断することは難しい.虫垂炎や回盲部腫瘍として切除後,病理組織学的に虫垂癌と判明する事が多い.<br> 68歳の女性が右下腹部の手拳大の腫瘤と圧痛を主訴に来院した. 3カ月前の注腸検査では虫垂内腔に一部透亮像を認めるが虫垂は明瞭に描出され回盲部にも異常を認めなかったため急性虫垂炎と診断,開腹した.所見は虫垂周囲膿瘍による腫瘤形成でドレナージにとどめ約1カ月後炎症が鎮静化した後虫垂切除を行った.病理組織学的に原発性虫垂癌と診断され虫垂切除端に癌細胞が陽性であったので更に8日後にリンパ節郭清を含む右半結腸切除術を追加した.切除虫垂の病理組織学的検査は不可欠で,特に腫瘤を形成した回盲部疾患では虫垂悪性腫瘍を念頭に入れておかねばならない.虫垂癌は稀であるがリンパ節郭清を含む右半結腸切除術を要するためその診断,治療に充分な配慮が必要である.

Primary cancer of the appendix is a rare entity which is hardly diagnosed preoperatively. It is often diagnosed histologically after resection of the lesion as appendicitis or ileocecal tumor.<br> A 68-year-old woman was admitted to the hospital because of a fist-sized tumor in the right lower abdomen and tenderness. On Barium enema performed 3 months before admission, the appendix was clearly visualized and no abnormalities were seen in the ileocecum. Laparotomy was carried out under a diagnosis of acute appendicitis. It revealed tumor formation due to periappendiceal abscess, and so drainage was done. About one month later when inflammation was alleviated, appendectomy was performed. The pathological diagnosis was made after the surgery with positive cancer cells on the stump of the resected appendix. Right hemicolectomy was subsequently performed on the 8th postoperative day. We must carefully examine the pathological findings of the resected specimen of the appendix entertaining a possible malignant lesion of the organ, especially for tumor-forming lesions.

収録刊行物

  • 日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society

    日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society 57(4), 908-912, 1996-04-25

    Japan Surgical Association

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各種コード

  • NII論文ID(NAID)
    10008520612
  • NII書誌ID(NCID)
    AN00198696
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    03869776
  • データ提供元
    CJP書誌  J-STAGE 
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