非霍奇金淋巴瘤骨髓移植后产生的阑尾腺癌:一个不寻常的治疗困境

J. Schwartz, B. Woods, L. Emerson, R. Andtbacka
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引用次数: 0

摘要

阑尾肿瘤是一种罕见的肿瘤,约占阑尾切除标本的0.1%。多数表现为急性阑尾炎,采用单纯阑尾切除术治疗。虽然存在争议,但在阑尾切除术时发现腹膜癌的情况下,细胞减少和腹腔内高温化疗(HIPEC)可能是潜在的治疗选择。然而,关于患者的选择、生活质量和手术相关的发病率、有效的细胞减少是什么,以及在没有腹腔化疗的情况下,单独的细胞减少是否能提供生存益处,存在争议。本文报告一例罕见的非霍奇金淋巴瘤骨髓移植后发生的阑尾穿孔腺癌。腹膜癌在这种情况下的发生以前没有报道,但例证了基于患者表现的个体化治疗方法的重要性。
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Appendiceal Adenocarcinoma Arising after Bone Marrow Transplantation for Non-Hodgkin Lymphoma: An Unusual Treatment Dilemma
Appendiceal tumors are rare neoplasms occurring in approximately 0.1% of appendectomy specimens1. The majority present as acute appendicitis and are treated by simple appendectomy. Although controversial, in the setting of peritoneal carcinomatosis discovered at the time of appendectomy, cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) may represent potential therapeutic options. However, debate exists with regard to patient selection, quality of life and procedureassociated morbidity, what constitutes effective cytoreduction, and whether cytoreduction alone offers a survival benefit in the absence of intraperitoneal chemotherapy. This report describes a rare case of a perforated appendiceal adenocarcinoma arising after bone marrow transplantation for non-Hodgkin lymphoma. The occurrence of peritoneal carcinomatosis in this setting has not previously been reported, but exemplifies the importance of an individualized approach to therapy based on a patient’s presentation.
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