- 期刊
Signet-Ring Cell Carcinoma of the Appendix: Report of a Case
闌尾印環細胞癌：一病例報告
摘要
闌尾原發性印環細胞癌是非常少見的。闌尾的印環細胞癌往往診斷較晚，因為臨床症狀到疾病晚期才會發生。到目前為止，印環細胞癌的致癌因子、自然病史、與臨床表現依然未明。我們報告一位66歲男性病人腹脹、食慾不佳半個月，電腦斷層顯示小腸腫脹而轉換部位在迴腸末端。大腸鏡檢查發現盲腸處有一顆8 mm的突起腫塊，腫塊有少許的中央凹陷與潰瘍，病理切片下顯示此腫塊瀰漫許多增生性細胞，這些增生細胞的細胞質富含黏液。後續患者接受右側結腸切除術與右側睪丸切除術，最後診斷為闌尾印環細胞癌合併大腸、迴腸、大網膜、皮膚、與右側睪丸轉移，病理分期T4aN2bM1b，屬於第IVB期。目前闌尾印環細胞癌的治療包含右側結腸切除術可合併或不合併腹腔溫熱化學治療。患者於術後九個月仍存活，目前接受術後化學治療中。
並列摘要
Primary signet-ring cell carcinoma of the appendix is extremely rare and is typically diagnosed at an advanced stage. To date, the carcinogenetic factors, natural history, and clinical behavior of this condition remain unclear. We report a case of a 66-year-old man who was suffering from abdominal distention, difficult defecation, and poor appetite for approximately half a month. Computed tomography showed dilatation of most small intestinal loops, with a transitional zone over the distal ileum. Colonoscopy showed an 8-mm elevated nodule with a mild central depression and ulceration at the cecum. The mass was shown to be infiltrated by signet-ring cell carcinoma histologically. Right hemicolectomy was performed, and the final diagnosis was advanced signet-ring cell carcinoma of the appendix, stage IVB (pT4aN2bM1b, AJCC-7th ed). The cancer had metastasis to the colon, ileum, omentum, skin, and right testis. Currently, the patient is alive 9 months after hemicolectomy and is undergoing chemotherapy with 5-fluorouracil and oxaliplatin.
延伸閱讀
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