虫垂切除術後２０年目に切除断端に発見された虫垂嚢腫の１例

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  • A case of appendiceal mucinous cyst detected 20 years after an appendectomy.

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This paper describes a case of appendiceal mucinous cyst which presented with high CEA level 20 years after an appendectomy for acute appendicitis. The cyst was thought to arise in the remnant surgical stump of the appendix.<br> The patient was a 65-year-old woman. There were previous histories of undergoing an appendectomy for acute appendicitis at the age of 45, and undergoing a resection of the lower esophagus and a total gastrectomy with associated resection of the pancreas and spleen for cancer (squamous cell carcinoma) of the esophagogastric junction at the age of 56. After the gastrectomy, the patient has been followed up, without any sign of recurrence. Thereafter, CEA level increased to 7.4ng/ml in March 1999. Various examinations performed with a suspicion of gastrointestinal lesion disclosed a cystic lesion in the cecum. The patient was operated on in June of the year.<br> Based on laparotomy findings and intraoperative ultrasound, cyst arising in the surgical stump of appendix was diagnosed. Since no malignancy was demonstrated by intraoperative frozen section diagnosis, a partial appendectomy including the cyst was performed. Pathological diagnosis was artificial retention cyst. CEA level contained in thecystic fluid was as abnormally high as 63, 200ng/ml even after it was diluted CEA level decreased to 6.8ng/ml on the 10th postoperative day.

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