虫垂無茎性鋸歯状病変における異所性骨化と同時発生神経内分泌腫瘍

Paul J Wurtz¹, Douglas Walton², Calen Gist³

¹Department of Internal Medicine, Brooke Army Medical Center, San Antonio, TX.

|December 26, 2025

Abstract:

Heterotopic ossification (HO) in colorectal polyps is rare and scarcely reported in serrated lesions. We report an appendiceal sessile serrated lesion (SSL) with mature bone and a contiguous well-differentiated neuroendocrine tumor. A 64-year-old woman had a firm appendiceal-orifice polyp biopsied in 2012 showing calcification; SSL was identified in 2019. In 2024, an 8-mm lesion was removed en bloc by underwater cold snare; histology showed SSL with HO. Laparoscopic appendectomy confirmed residual SSL with HO and an adjacent 4.5-mm grade-1 neuroendocrine tumor (INSM1+, Ki-67 <3%) with negative margins. HO recognition should prompt en bloc excision and attentive pathology.

キーワード:

虫垂口大腸ポリープ異所性骨化神経内分泌腫瘍骨様化生無茎性鋸歯状病変水中コールドスネア

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