帝王切開時の偶発的発見としての低異型度虫垂粘液性腫瘍:症例報告
Vesna Paunovic1, Tomislav Paunovic1, Aleksa Jokic1
1University Obstetrics and Gynecology, Clinic "Narodni Front", Belgrade, Serbia.
The American journal of case reports
|December 23, 2025
まとめ
低異型度虫垂粘液性腫瘍(LAMN)は稀な腫瘍である。この症例は帝王切開時の偶発的発見を強調し、適時診断と管理のための術中警戒の重要性を強調する。
科学分野:
- 消化器病学
- 婦人科
- 腫瘍学
背景:
- 虫垂粘液性腫瘍(AMN)は稀な虫垂腫瘍(0.2-0.7%)である。
- 低異型度AMN(LAMN)は女性に多く、症状が不明瞭なため虫垂炎に似ている。
- LAMNは粘液の蓄積、虫垂の拡張、および偽粘液腫腹膜(PMP)のリスクを伴う。
研究 の 目的:
- 帝王切開中に偶発的に発見されたLAMNの稀な症例を報告する。
- 妊娠中のLAMNの診断上の課題を強調する。
- 術中警戒と集学的管理の重要性を強調する。
主な方法:
- 45歳妊婦の症例報告。
- 選択的帝王切開時の偶発的な術中発見。
- 虫垂切除術、生検、CA125測定後、右半結腸切除術および大網切除術を実施。
主要な成果:
- 40週の妊娠患者において、帝王切開中に偶発的にLAMNが発見された。
- 術中所見では、400mlの粘液(PMP)と虫垂腫瘤が認められた。
- 術後病理検査で、粘液播種を伴うLAMNが確認された。
結論:
- 帝王切開時のLAMNの偶発的発見は極めて稀である。
- 術中の警戒と徹底的な腹部評価が不可欠である。
- 最適な母体および新生児の転帰のためには、集学的管理が不可欠である。
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