原発性虫垂癌の1例

DOI Web Site 被引用文献14件 参考文献6件

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  • PRIMARY ADENOCARCINOMA OF THE APPENDIX-A CASE REPORT AND A REVIEW OF 132 CASES IN JAPAN-

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This paper describes a case of primary adenocarcinoma of the appendix in a 53-year-old woman, together with an analysis of 132 cases seen in the Japanese literature from 1985 to 1995. The patient was admitted to the hospital because of right lower quadrant pain lasting for about one month when the pain was repeatedly intensified and relieved. With abdominal ultrasonography and computed tomography, a preoperative diagnosis of ileocecal abscess associated with appendicitis was made. An ileocecal resection including a two-third portion of the oral side ascending colon was performed. Histologically it was adenocarcinoma of the appendix. In a review of 132 cases reported in Japan in a recent decade, the chief complaints were unspecific such as right lower quadrant pain in 40%, abdominal mass in 14% and genitourinary complaint in 11% of the cases. Twenty-one patients had no symptoms caused by the appendiceal lesion. Preoperative diagnosis was made as acute appendicitis in 26%, cecal cancer in 6%, cancer of the ascending colon in 4%, ileocecal mass in 3% and cancer of the sigmoid colon in 2%, whereas cancer or tumor of the appendix in 20%. Another review of Japanese cases before 1987 shows that the correct preoperative diagnosis was made in much fewer cases than those of the last 10 years. In our review the number of the patients diagnosed as appendiceal carcinoma or appendiceal tumor, who preoperatively underwent ultrasonography, computed tomography, barium enema, or colon fiberscopy, was double of those whose preoperative diagnoses were incorrect. This fact shows that these methods should be tried to improve the preoperative correct diagnosing rate.

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