Primary Appendiceal Malignancy: A Clinicopathologic Study

原發性蘭尾癌是很稀有腫瘤。我們分析在花蓮慈濟醫院這種罕見癌症之臨床病理特性及預後。我們分析十年來本院蘭尾手術病例中經病理診斷爲蘭尾惡性腫瘤個案。本研究共有8位病人：7個男性及1位女性。平均年齡66歲（59-78歲）。3位是黏液性腺癌，2位大腸型腺癌及3位腺類癌。沒有一位在術前診斷，而有5位術前診斷爲急性蘭尾炎。手術方式包括4位接受右側大腸切除術或部份大腸切除術，3位接受右側大腸切除術及腹部腫瘤根除術而另一位只作蘭尾切除術。我們平均追蹤64個月（3-12個月），發現腺類癌預後比起腺癌有較好預後。我們研究資料顯示原發性蘭尾癌重要預後指標包括組織病理分型及腫瘤散佈範圍。在我們研究系列發現不管有無接受化學治療，姑息性切除散佈病灶能夠延長病人壽命。

關鍵字

腺類癌；蘭尾癌；大腸型腺癌；黏液性腺癌；僞黏性腹膜炎

並列摘要

Primary appendiceal cancer is a rare neoplasm. We analyzed the clinicopathologic characteristics and clinical outcomes of patients with primary appendiceal cancer treated at Buddhist Tzu Chi General Hospital in Eastern Taiwan. We reviewed the medical records of patients who had appendectomy at our hospital over a 10-year period and studied those who had histologically proven malignant appendiceal neoplasms. We treated eight such patients: seven males and one female. Their median age was 66 years (range, 59-78 years). There were three mucinous adenocarcinomas, two colonic type adenocarcinomas, and three adenocarcinoids. No patient was diagnosed correctly before surgery, and five (62.5%) had a preoperative diagnosis of acute appendicitis. Operative procedures included right hemicolectomy or partial colectomy in four, debulking and right hemicolectomy in three, and appendectomy only in one. With a mean follow-up of 64 months (range, 3-132), patients with adenocarcinoid lesions had better prognosis than those with adenocarcinomas. The important prognostic factors of primary appendiceal cancer included histologic subtypes and the extent of dissemination. In our series, palliative resection for disseminated lesions with or without additional chemotherapy resulted in long-term survival.

並列關鍵字

adenocarcinoid ； appendiceal cancer ； colonic type adenocarcinoma ； mucinous cystadenocarcinoma ； pseudomyxoma peritonei

國際替代計量

Primary Appendiceal Malignancy: A Clinicopathologic Study

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