腸閉塞を来した虫垂原発内分泌細胞癌の１例

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  • A Case of Neuroendocrine Cell Carcinoma of the Appendix as a Cause of Bowel Obstruction

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We report a case of neuroendocrine cell carcinoma of the appendix vermiformis found in bowel obstruction. A 62-year-old woman with symptoms of bowel obstruction was found in computed tomography (CT) and endoscopy to have a mass in the cecum and ascending colon that cmpressed the terminal ieum. CT also showed swollen lymph nodes at the mesentrium and paraaorta. Pathological examination of an endoscopic biopsy specimen in showed the tumor to be poorly differentiated colon adenocarcinoma. After recovering the obstruction in treatment by ileus tube, we conducted right colectomy with paracolic lymph node dissection. Histo logical examination showed that the tumor was originated from the appendix vermiformis, expanded to the subserosal layer, and developed to ileocolic valve in the submucosal layer causing the bowel obstruction. The tumor consisted mainly of neuroendocrine cell carcinoma positive for Grimelius staining and immunohistochemically positive for chromogranin A and NSE. Minor areas of the tumor showed mucinous carcinoma. She died of cancer 10 months after surgery. Neuroendocrine cell carcinoma of the appendix vermiformis is rare and only 3 cases, including ours, have been reported in the literature.

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