一位年輕盲腸腺癌病患以急性闌尾炎為表徵

A Young Patient with Cecal Carcinoma Presenting as Acute Appendicitis

莊樹宏(Shu-Hung Chuang) ； 林鉷彬(Hung-Bun Lam) ； 劉建國(Chien-Kuo Liu) ； 王道遠(Tao-Yeuan Wang) ； 陳碧芳(Be-Fong Chen) ； 李居仁(Jie-Jen Lee)

《中華民國癌症醫學會雜誌》 25卷5期 (2009/10) Pp. 386-390

https://doi.org/10.6588/JCOS.2009.25.5.10

摘要

急性闌尾炎可由盲腸腫瘤阻塞闌尾管腔所引發，同時也可能是診斷盲腸腫瘤的重要線索。一位38歲女性急性闌尾炎病患，於闌尾切除術中發現同時伴有發炎性盲腸質塊。六週後她接受大腸鋇劑攝影及大腸鏡切片檢查，確診為盲腸腺癌，隨即接受右半結腸切除手術，術後恢復良好，迄今未發現有復發或轉移。四十歲以上或小於四十歲但其臨床表現不典型或術中有異常發現的急性闌尾炎病患，應於闌尾切除術後六週接受大腸鋇劑攝影或大腸鏡檢查。在闌尾切除術中意外發現伴有盲腸質塊時，逕行廻盲段局部切除或右半結腸切除的合理性，有待更進一步的研究來探討。

關鍵字

盲腸腺癌 ； 急性闌尾炎 ； 盲腸質塊

並列摘要

Obstruction of the lumen of the appendix by cecal neoplasm can induce acute appendicitis. It may be the only clue to the presence of a cecal tumor. In this repot, an inflammatory cecal mass was found during the appendectomy in a 38-year-old woman presenting as acute appendicitis. She underwent double contrast barium enema study at postoperative week six. Subsequent colonoscopic biopsy revealed cecal adenocarcinoma. Right hemicolectomy was performed uneventfully. There is no evidence of local recurrence or distant metastasis after 15 months of follow-up. We suggest that double contrast study or colonoscopy should be performed after appendectomies in patients over 40 years presenting with acute appendicitis or those under 40 years with atypical clinical presentation or abnormal intraoperative findings. The rationale of ileocecal resection or right hemicolectomy for incidental cecal mass found during appendectomies needs further investigation.

並列關鍵字

cecal carcinoma ； acute appendicitis ； cecal mass