発見契機が異なる虫垂粘液嚢胞腺腫の3例

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  • THREE CASES OF MUCINOUS CYSTADENOMA OF THE APPENDIX PRESENTED WITH DIFFERENT PROCESSES

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We report three cases of mucinous cystadenoma of the appendix presented with different processes, and discuss recent trends of preoperative diagnosis and treatment for the disease in a review of 64 cases seen in the Japanese literature for recent 5 years. [Case 1] A 69-year-old man was detected a high level of serum CEA during an examination for his complaint of appetite loss. Mucinous cystadenoma of the appendex was diagnosed by imaging studies. [Case 2] An 85-year-old woman had been performed herniorrhaphy for femoral hernia. The removed hernia sac contained mucinous tumors, which were suspected pseudomyxoma peritonei by a histological examination. The patients was operated on without any differential diagnosis from ovarian cyst, and appendiceal mucocele was revealed. [Case 3] A 68-year-old woman was incidentally detected having a cystic mass in the right lower abdomen by ultrasonogra-phic study at a medical check up. The disease was diagnosed by close examinations. In all these cases partial cecectomy was performed. In a review of the literature, a recent increase in the rate of correct preoperative diagnosis for this disease has been shown. However the disease still presents difficulty in distinguishing between benign and malignant tumors. Then, extensive operations more than ileocecal resection were selected in over half the cases. We suggest that minimally invasive surgery should be selected at primary laparotomy, following enough informed consent about a possibility of re-operation.

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