巨大阑尾黏液囊肿：一例报道与诊疗分析

Gigantic Appendiceal Mucocele: A Case Report and Analysis of Diagnosis and Treatment

摘要: 患者女，63岁，主诉右下腹部肿块3个月，门诊以结肠肿物收入院。查体在右下腹部触及13 cm × 8 cm × 6 cm 大小包块、质硬、活动、边界欠清。实验室检查：Hb 12.4 g/L、CEA 5.4 μg/L、CA125 24.4 U/mL、CA153 9.6 U/mL及CA19-9 < 2.0 U/mL。B超检查示下腹部条索状囊性包块(首先考虑肠道来源)；腹部CT扫描示盆腔右侧囊性占位性病变；结肠镜检查示回盲部外压性肿物。连硬麻醉下行剖腹探查，术中见右下腹部有一个15 cm × 8 cm × 5 cm腊肠样囊性肿物。术中冰冻病理组织学检查诊断为阑尾黏液囊肿。故决定行阑尾切除术，术后第4天痊愈出院。 A 63-year old female complained of right lower abdominal mass for 3 months, and she was admitted to hos- pital with a diagnosis colon tumor. On physical examination, an abdominal mass was found in her right quadrant, sized in 13 cm × 8 cm × 6 cm, hard, movable with clear margin. Laboratory examination revealed that Hb 12.4 g/L, CEA 5.4 μg/L, CA125 24.4 U/mL, CA153 U/mL and CA19-9 < 2.0 U/mL. A cord-like cystic mass in right abdominal cavity, primitive impression of gastrointestinal tumor, was detected by ultrasound examination, and CT scan demonstrated that a cystic occupation in right pelvic cavity, and exophytic tumor at cecum was found by fibrocolonoscopy. An exploratory laparotomy underwent by epidural anesthesia, a sausage-like tumor with size of 15 cm × 8 cm × 5 cm was seen at right abdominal cavity, and a diagnosis of appendiceal mucocele was made by intraoperative frozen pathological examination, then an appendectomy was performed, ad the patient recovered smoothly after operation and discharged on the 4th op- eration day.