Reduced Port Surgeryで切除した高度炎症を伴う虫垂中に発見された潜在性虫垂粘液嚢胞腺腫の１例

Appendicitis is a benign disease for which surgical treatment is widely provided. The complication of neoplastic lesions may be discovered only after resection. However, in some cases, specimens are not submitted to histopathological examination in Japan because of an extreme deficiency of pathologists. We report our experience with one patient who experienced the complication of latent low-grade appendiceal mucinous neoplasm (LAMN) after surgery for appendicitis. Our patient was an 85-year-old woman. Conservative treatment failed to relieve fever and lower abdominal pain and it was decided to treat her surgically. Abdominal computed tomography (CT) showed appendicitis with severe inflammation and suspected adhesion. We decided to explore the abdominal cavity using a reduced-port laparoscopic approach. We found no mucous debouchment or clear tumors in the specimen. Histopathological findings indicated the coexistence of appendicitis and LAMN. At one year and a half after surgery, there was no evidence of the development of pseudomyxoma peritonei. In appendectomy, it is thought that careful perioperative treatment and a postoperative pathological search are important when there are no preoperative findings suggesting a neoplastic lesion.

症例報告 (Case Reports)