内容紹介
Summary
The patient was a 26-year-old female who had undergone conservative treatment for acute appendicitis at another clinic and was referred to our hospital for interval appendectomy. We performed a single-incision laparoscopic appendectomy, and the patient was diagnosed with goblet cell carcinoid(GCC)based on the postoperative pathological examination. Since GCC is considered a high-grade tumor, we performed a laparoscopic ileocolic resection with D3 lymphadenectomy. There was no residual disease or lymph node metastasis detected in the resected specimen. Patients with advanced GCC typically have poor prognosis, because GCC is characterized by peritoneal dissemination and lymph node metastasis. However, our findings suggested that an additional laparoscopic surgery could be one of the curative and safe treatment options for selected patients with GCC.
要旨
症例は26歳,女性。前医で急性虫垂炎に対し保存治療を行い,interval appendectomyを希望され当院に紹介となった。当院にて単孔式腹腔鏡下虫垂切除術を施行したが,術後の病理組織学的検査で虫垂杯細胞カルチノイド(goblet cell carcinoid: GCC)と診断された。GCCは生物学的悪性度が高いため,D3郭清を伴う腹腔鏡下回盲部切除術を行った。切除標本に遺残病変,リンパ節転移を認めなかった。GCCは進行例では腹膜播種・リンパ節転移を伴い予後不良な疾患であるが,症例によっては腹腔鏡下手術による追加切除は安全に施行できる根治性のある治療法の一つと考えられた。
目次
The patient was a 26-year-old female who had undergone conservative treatment for acute appendicitis at another clinic and was referred to our hospital for interval appendectomy. We performed a single-incision laparoscopic appendectomy, and the patient was diagnosed with goblet cell carcinoid(GCC)based on the postoperative pathological examination. Since GCC is considered a high-grade tumor, we performed a laparoscopic ileocolic resection with D3 lymphadenectomy. There was no residual disease or lymph node metastasis detected in the resected specimen. Patients with advanced GCC typically have poor prognosis, because GCC is characterized by peritoneal dissemination and lymph node metastasis. However, our findings suggested that an additional laparoscopic surgery could be one of the curative and safe treatment options for selected patients with GCC.
要旨
症例は26歳,女性。前医で急性虫垂炎に対し保存治療を行い,interval appendectomyを希望され当院に紹介となった。当院にて単孔式腹腔鏡下虫垂切除術を施行したが,術後の病理組織学的検査で虫垂杯細胞カルチノイド(goblet cell carcinoid: GCC)と診断された。GCCは生物学的悪性度が高いため,D3郭清を伴う腹腔鏡下回盲部切除術を行った。切除標本に遺残病変,リンパ節転移を認めなかった。GCCは進行例では腹膜播種・リンパ節転移を伴い予後不良な疾患であるが,症例によっては腹腔鏡下手術による追加切除は安全に施行できる根治性のある治療法の一つと考えられた。