術前診断しえた原発性早期虫垂腺癌の１例

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  • A Case of Early Primary Adenocarcinoma of the Vermiform Appendix Diagnosed Preoperatively.

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A 79-year-old woman was admitted to the hospital because of right lower abdominal pain and constipation. We suspected acute appendicitis and a cecal tumor by an abdominal CT scan and other imagings. After symptomatic remission was attained by conservative treatment, we performed more close examination. CT scan of the abdomen showed dilatation of the vermiform appendix and a cecal mass. Colonoscopy demonstrated an easily bleeding protruded lesion with central depression at the end of the cecum, and the orifice of the appendix was undetected. Histological examination of the biopsy specimens from the cecal tumor demonstrated tubulovillous tumor, Group 4. Under a diagnosis of appendiceal adenocarcinoma, an ileocecal resection was performed. Pathological examination showed well differentiated adenocarcinoma in tubulo-villous adenoma with submucosal invasion. No lymph node metastasis was recognized. In instances in which carcinoma of the vermiform appendix is suspected, we should perform colonoscopy, and in instances in which circular fold, elevated lesion and a mass similar to submucosal tumor at the end of the cecum are recognized, we should suspect carcinoma of the vermiform appendix.

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