| 刘志星,吴钦炎,简国亮,等.急性阑尾炎术后漏诊阑尾杯状细胞腺癌1例并文献复习[J].安徽医药,待发表. |
| 急性阑尾炎术后漏诊阑尾杯状细胞腺癌1例并文献复习 |
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| 投稿时间：2026-06-28 录用日期：2026-07-21 |
| DOI： |
| 中文关键词: 阑尾杯状细胞腺癌、急性阑尾炎、肠道超声、双重造影、肠梗阻 |
| 英文关键词: |
| 基金项目:2023年度广东省基础与应用基础研究基金佛山市联合基金(粤佛联合基金)地区培育项目(2023A1515140118) |
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| 中文摘要: |
| 目的 总结阑尾杯状细胞腺癌（GCA）的临床病理特征及影像学表现，分析其漏诊原因，并探讨多学科诊疗策略。方法 回顾分析1例急性阑尾炎术后漏诊GCA患者的临床资料，并复习相关文献。结果 53岁男性患者，7年前因急性阑尾炎行阑尾切除术，术后病理未提示肿瘤。本次因“肠梗阻”入院。肠道超声双重造影发现回盲部实性占位，考虑恶性肿瘤。小肠镜活检及多学科团队（MDT）复核既往病理切片，确诊为阑尾杯状细胞腺癌并回盲部转移。经手术减瘤联合腹腔热灌注化疗及综合化疗，随访16个月未见肿瘤复发。结论 本病例提示，对于中老年急性阑尾炎患者，术后病理应警惕GCA可能，必要时行免疫组化筛查；肠道超声双重造影有助于早期发现隐匿性占位。 |
| 英文摘要: |
| Objective To summarize the clinicopathological features and imaging findings of appendiceal goblet cell adenocarcinoma (GCA), analyze the causes of missed diagnosis, and explore multidisciplinary treatment strategies.Methods The clinical data of a patient with GCA missed after acute appendicitis surgery was retrospectively analyzed, and the relevant literature was reviewed.Results A 53-year-old male patient had undergone appendectomy for acute appendicitis 7 years prior, with no tumor identified on postoperative pathology. He was admitted for intestinal obstruction. Intestinal double contrast-enhanced ultrasound revealed a solid mass in the ileocecal region, suggestive of malignancy. Biopsy via enteroscopy and re-evaluation of previous pathology slides by a multidisciplinary team (MDT) confirmed the diagnosis of appendiceal goblet cell adenocarcinoma with ileocecal metastasis. Following cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy and systemic chemotherapy, no tumor recurrence was observed during the 16-month follow-up.Conclusions This case suggests that for middle-aged and elderly patients with acute appendicitis, postoperative pathological examination should raise the suspicion of GCA, and immunohistochemical staining should be considered when necessary. Intestinal double contrast-enhanced ultrasound can facilitate the early detection of occult masses. |
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