Two-stage Curative Surgery in a Case of Perforation of the Appendix by Primary Neuroendocrine Cell Carcinoma

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  • 二期的根治術を行った虫垂原発神経内分泌細胞癌穿孔の1例
  • ニキテキ コンジジュツ オ オコナッタ チュウスイ ゲンパツ シンケイ ナイブンピ サイボウガン センコウ ノ 1レイ

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Abstract

<p>A 76-year-old woman presented at a local clinic complaining of generalized abdominal pain, diarrhea, and fever, and was referred to our hospital for further investigation and treatment. Diagnostic imaging showed generalized peritonitis due to appendiceal perforation, and emergency laparoscopic appendectomy was performed. The pathological diagnosis was appendiceal endocrine cell carcinoma. Since no lymph node or distant metastasis was evident on postoperative imaging, it was decided to carry out curative surgery after intraperitoneal observation by staging laparoscopy. In this second operation, no obvious disseminated nodules were observed, and ileocolic resection and D3 lymph node dissection were performed. There was no residual cancer in the resected specimen, and no lymph node metastasis was evident.</p><p>Primary appendiceal neuroendocrine cell carcinoma is extremely rare and has a poor prognosis, showing rapid growth and high rates of vascular invasion and metastasis. As in the present case, curative treatment may be possible for some patients, although they will still require careful follow-up, and this case suggested that two-stage curative treatment should be considered an option for patients with appendiceal perforation, without squandering the opportunity.</p>

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