原発性虫垂癌の５例

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  • Five Cases of Primary Carcinoma of the Vermiform Appendix.

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We treated 5 cases of primary carcinoma of the vermiform appendix. The incidence of appendectomy was 5/247 (2.02%) and colorectal cancer resection 5/361 (1.39%) from July 1986 to March 2000 at our hos- pital. The mean male age (3 cases) and female (2 cases) patients was 59.2 years. Four cases were prediagnosed as acute appendicitis and one as mucocele. Pathological examination showed 3 were well differentiated adeno- carcinomas, 1 was cystoadenocarcinoma, and 1 was mucinous carcinoma. Ileocecal resection was conducted in 3 cases and right hemicolectomy in 2. Three cases were treated by additional surgery after appendectomy. Primary carcinoma of the vermiform appendix is rare and preperative diagnosis difficult, so it is important to conduct preoperative X-ray examination, careful intrapoerative inspection, and postoperative pathological ex- amination. Although radical surgery involving lymph node dissection in advanced cancer and appendectomy as routine in early cancers with undefined preoperative diagnosis are common, additional surgery in early cancer should follow procedures designed for advanced cancer if the tumor has invaded the submucosa. Ap- pendectomy is adequate if the tumor has not invaded the marginal layer, and closure of the stump is possoble if tumors are limited to mucosa. With data on these issues not yet available, cases and follow-up sutdies should be collected to detemine appropriate operative procedures in each case.

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