Low-Grade Appendiceal Mucinous Neoplasm: A Rare Cause of Acute Abdomen
摘要
Purpose. Low-grade appendiceal mucinous neoplasm (LAMN) is a rare type of appendiceal cancer. Patients with LAMN may initially present with acute abdominal pain. Despite the use of CT, ultrasound or colonoscopy, preoperative diagnosis is difficult. In this study, we retrospective analyze cases of LAMN diagnosed in the past 10 years in Chang-Hua Christian Hospital and review the associated literature.Materials and Methods. This study retrospectively analyzed 15 patients who underwent surgery and was histopathologically confirmed LAMN at Chang-Hua Christian Hospital between January 2000 to August 2011. Patient charts and data on patient demographics; clinical features; ultrasonography (US), colonoscopy and computed tomography (CT) findings; pathology reports; pre-operative diagnosis and operative method were reviewed.Results. The were 15 cases of LAMN at Chang-Hua Christian Hospital over the past ten years. In our review, there were eight (53.3%) female patients. The median age was 67 years (47-85 years), and the most common presentation was abdominal pain (93.3%). On US in six patients, findings were abdominal cystic mass and cyst wall calcification. The CT finding was well-encapsulated cystic mass in thirteen patients. Appendectomy was performed in ten patients. Right hemicolectomy was performed in five patients, and there was one patient found concomitant colon adenocarcinoma in the specimen.Conclusion. LAMN is difficult to diagnose before operation. The actual diagnosis is usually made intraoperatively or during histopathologic examination of the excised specimen. Although surgical treatment is straightforward, proper management of the incidentally found lesion requires understanding of the potential complications of widespread peritoneal disease. It should be kept in mind that LAMN may coexist with other neoplasms, and follow-up colonoscopy and pelvic examination is warranted for the high association with other colon and ovarian malignancies.