[一例由脓肿形成性阑尾炎发展而来的阑尾粘液腺癌伴膀胱侵犯,化疗后治愈切除】。]

Q4 Medicine Japanese Journal of Cancer and Chemotherapy Pub Date : 2024-08-01
Yuki Yoshihara, Takuji Kagiya, Yoshiyuki Sakamoto, Hajime Morohashi, Takuya Miura, Kazuki Yokoyama, Kenichi Hakamada
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引用次数: 0

摘要

患者是一名 35 岁的男子,以排尿疼痛为主诉首次就诊。腹部造影剂增强 CT 扫描显示,诊断为脓肿形成性阑尾炎,炎症扩散至膀胱,因此决定保守治疗。由于抗生素治疗未能缩小脓肿,他接受了手术。膀胱壁高度发炎,只能进行阑尾切除术。病理结果显示阑尾粘液癌侵犯了膀胱,因此他被转到了我们科室。由于需要进行全膀胱切除术才能达到根治性切除,而且担心初次手术会造成播种,因此他被判定为无法切除,并接受了化疗。在接受了 6 个疗程的 CAPOX+bevacizumab 治疗后,由于没有远处转移且肿瘤缩小,他接受了保留膀胱的根治性切除术。术后 6 个月,他的病情依然稳定,没有复发。我们在此报告这例脓肿形成性阑尾炎引起的膀胱侵犯性阑尾粘液癌,并对相关文献进行了讨论。
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[A Case of Appendiceal Mucinous Carcinoma with Bladder Invasion Developed from Abscess-Forming Appendicitis, Which Was Curatively Resected after Chemotherapy].

The patient was a 35-year-old man who saw his first doctor with the chief complaint of painful urination. A contrast- enhanced CT scan of the abdomen revealed a diagnosis of abscess-forming appendicitis with inflammatory spread to the bladder, and conservative treatment was decided. Since antibiotic treatment failed to reduce the size of the abscess, he underwent surgery. The bladder wall was highly inflamed, only appendectomy was performed. Pathology revealed appendiceal mucinous carcinoma invading the bladder, so he was referred to our department. Because a total cystectomy was required for curative resection and there was concern about seeding associated with the initial surgery, he was judged to be unresectable, and received chemotherapy. After 6 courses of CAPOX+bevacizumab therapy, he was able to have a bladder- sparing curative resection because of the absence of distant metastasis and shrinkage of the tumor. He remains stable without recurrence 6 months after surgery. We herein report, with some discussion of the literature, this case of bladder-invading appendiceal mucinous carcinoma arising from abscess-forming appendicitis, for which a curative resection was possible after chemotherapy.

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[Ⅰ. Current Topics in Pleural Mesothelioma]. [Ⅱ. Updates on Therapeutic Strategies for Malignant Mediastinal Tumors]. [Ⅲ. Latest Topics of Lung Neuroendocrine Neoplasms]. [A Case of Appendiceal Mucinous Carcinoma with Bladder Invasion Developed from Abscess-Forming Appendicitis, Which Was Curatively Resected after Chemotherapy]. [A Case of Intestinal Lymphoma with Two Perforation in a Short Period Time].
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