The patient was a 17-year-old female who presented with lower abdominal pain. She was initially suspected of having a periappendiceal abscess or an appendiceal tumor, leading to a referral to our hospital for further assessment. A definitive diagnosis was not reached from preoperative test results; however, with the possibility of an appendiceal malignancy in mind, a laparoscopic ileocecal resection was performed. Rapid intraoperative histopathological examination revealed adenocarcinoma, prompting additional procedures, including a D2 lymph node dissection, right adnexectomy, and partial retroperitoneal resection to complete the surgery in a single session. Histopathological examination confirmed invasion up to the muscularis propria with no lymph node metastasis found. Although it is rare, it is crucial to consider the possibility of malignancy in young patients exhibiting atypical progression or imaging findings of appendicitis.
"},{"@language":"ja","@value":"症例は17歳女性．下腹部痛を主訴に前医受診し，画像検査の結果，虫垂周囲膿瘍または虫垂腫瘤の疑いで当院紹介となった．術前検査からは確定診断に至らなかったが，虫垂悪性腫瘍の可能性を念頭におき腹腔鏡下回盲部切除術を行った．術中迅速組織検査の結果，adenocarcinomaであることが判明したため，D2リンパ節郭清術，右付属器切除術，後腹膜部分切除術を追加し，一期的に手術を完遂した．病理検査の結果，固有筋層までの浸潤に留まっておりリンパ節転移は認めなかった．頻度は非常に低いが，非典型的な経過や画像所見を認める患者においては，若年者であっても悪性腫瘍の可能性を考慮することが重要である．
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