A Case of Low-grade Appendiceal Mucinous Neoplasm That Was Difficult to Diagnose

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  • 術前診断が困難であった腸閉塞をきたした低異型度虫垂粘液性腫瘍の1例
  • ジュツゼン シンダン ガ コンナン デ アッタ チョウ ヘイソク オ キタシタ テイイケイド チュウスイ ネンエキセイ シュヨウ ノ 1レイ

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Abstract

<p>The patient was an 88-year-old woman who presented with fever, vomiting and abdominal pain. Whole-body CT revealed bilateral pneumonia and small bowel dilatation, but no findings suggestive of neoplastic lesions. We started the patient on antibiotic therapy for treating the pneumonia and inserted an ileus tube for relief of the intestinal obstruction. While the pneumonia responded well to the treatment with antibiotics, the intestinal obstruction failed to be relieved by the conservative treatment, and surgery was needed. Exploratory laparotomy revealed small bowel dilatation, evidence of ischemia of the ileum due to strangulation by a band between the appendix and the retroperitoneum, and a cystic lesion of the appendix. Repositioning, appendectomy, and partial ileostomy were performed. The appendiceal cyst was 1.8 cm in diameter and the histopathological diagnosis was low-grade appendiceal mucinous neoplasm. We report this case, as there are only few case reports of small bowel obstruction caused by an appendiceal neoplasm.</p>

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