scholarly journals Surgical treatment of giant renal tumor: a case report

2021 ◽  
Vol 17 (3) ◽  
pp. 140-144
Author(s):  
V. R. Latypov ◽  
O. S. Popov ◽  
S. I. Novikov ◽  
V. N. Latypova ◽  
D. B. Ahmedov
Keyword(s):  
Surgical Treatment ◽  
Adrenal Gland ◽  
Renal Tumor ◽  
Malignant Tumors ◽  
Left Kidney ◽  
Renal Tumors ◽  
Histological Structure ◽  
Large Tumor ◽  
Satisfactory Condition ◽  
Poorly Differentiated

Renal tumors account for 2 to 3 % of all malignant tumors in adults. Of all patients with renal cell carcinoma, 30 to 40 % have advanced forms of the disease. In the literature, the term "giant renal tumor" is used for tumors larger than 20 cm. In this article, we report a case of surgical treatment for a giant malignant kidney tumor.Patient N., female, 54 years old, referred to an outpatient clinic with complaints of a change in the shape of the abdomen on the left with a palpable large tumor, abdominal pain, shortness of breath, weakness, constipation, episodes of blood in the urine and increased blood pressure. Body mass index 30.2 kg/m2. Ultrasound examination revealed a large tumor in the left retroperitoneal space. Laboratory testing of blood, urine was performed, findings were unremarkable. According to the data of magnetic resonance imaging, the left kidney was transformed into a large cystic solid formation, measuring 30.5 х 17.5 х 17.0 cm, heterogeneously accumulating a contrast agent with a solid component. Patient was admitted to the urology department for surgical treatment. We performed radical nephrectomy on the left with thoracolumbar laparotomy access on the left with resection of the 10th rib, resecting the renal tumor with the adrenal gland, total weight of the complex was 10.7 kg. The histological structure was determined as poorly differentiated renal carcinoma with invasion of the perinephric tissue. In the adrenal gland, fields of fresh erythrocytes with an admixture of tumor tissue were noted. Examined lymph node tissue was completely replaced by tumor cells. Postoperative period was characterized by episodes of dynamic intestinal obstruction. The patient was discharged from the department in a satisfactory condition on the 13th day after the operation, but died 1.5 months after discharge, the cause of death has not been established, as no autopsy was performed. Thus, the size of the tumor is not a contraindication to surgical treatment, which improves the survival rate of patients with malignant renal tumors.

scholarly journals SUPERSELECTIVE EMBOLIZATION OF THE RENAL ARTERIES AS A MONOTHERAPY OF KIDNEY TUMOR IN A PATIENT WITH HIGH ANESTHESIOLOGIC RISK

2021 ◽  
pp. 61-67
Author(s):  
V. K. Karpov ◽  
D. M. Kamalov ◽  
B. M. Shaparov ◽  
O. A. Osmanov ◽  
A. А. Kamalov
Keyword(s):  
Surgical Treatment ◽  
Renal Artery ◽  
Malignant Tumors ◽  
Left Kidney ◽  
Renal Arteries ◽  
Artery Embolization ◽  
Safe Alternative ◽  
X Ray ◽  
Superselective Embolization ◽  
Renal Artery Embolization

Introduction: Renal artery embolization is a minimally invasive X-ray endovascular operation that is used in the treatment of various urological diseases. This operation is of increasing interest due to its ability to occlude not only proximal, but also distal renal vessels with a low risk of complications. Recent developments in endovascular technology make embolization one of the effective and safe methods applicable to stop renal bleeding, preoperative preparation for surgical treatment of renal malignant tumors, and first-line treatment for angiomyolipomas. For a certain category of patients, renal artery embolization is practically no alternative method of treatment. This applies to comorbid patients with kidney tumors and aggravated somatic status, in whom the anesthetic risk makes open or laparoscopic surgical treatment impossible, and embolization can reduce symptoms, improve the quality of life of such patients and prolong the patient's life.Clinical case: we demonstrate the experience of X-ray surgical treatment of cT1aN0M0 left kidney cancer in an 80-year-old patient.Conclusion: Embolization of renal arteries in some cases can be an effective and safe alternative treatment for renal cell carcinoma in somatically burdened patients who cannot perform surgical treatment.

scholarly journals Histopathological finding as a prognostic factor of the surgical treatment outcome in colorectal cancer

2010 ◽  
Vol 67 (8) ◽  
pp. 638-643 ◽  
Author(s):  
Svetozar Secen ◽  
Nebojsa Moljevic ◽  
Milivoje Vukovic ◽  
Ljiljana Somer
Keyword(s):  
Colorectal Cancer ◽  
Treatment Outcome ◽  
Prognostic Factors ◽  
Surgical Treatment ◽  
Tnm Classification ◽  
Stage Iv ◽  
Histological Structure ◽  
Poorly Differentiated ◽  
The Impact ◽  
Stage D

Background/Aim. Adenocarcinomas of the colon are the most common malignant colorectal tumors. Macroscopic and histopahtological features of colorectal cancer significantly affect its outcome. The aim of this study was to analyze the impact of histopahological finding as a prognostic factor on the surgical treatment outcome and the course of the disease. Methods. In the first part of this study the distribution (numerical and proportional) of certain histopathological parameters in the examined groups of patients were reviewed; in the second part of the study the statistical significance of the impact of the certain elements of a histopahtological finding on the surgical treratment outcome was analyzed. The histopathological elements analyzed included: the hsitological tumor type grading according to Duke, ie Astler-Coller, and tumor, nodes, metastases (TNM) staging in the examined sample of 100 patients. Results. Statistically significant prognostic factors of the outcome of surgical treatment were selected after multivariant analysis. These factors comprise Astler-Coller-Dukes stage D (revealed in 77.78% patients died), stage IV according TNM classification (T1-4, N0-2, M1), histological structure (poorly diferentiated adenocarcinoma in 85.2% patents died) and type of tumor (mucynous adenocarcinoma was more often present in died, 77.78%). Since ? = 0.000 for four risk factors were formed using discriminant analysus, it was proved their significant influence on the outcome of surgical treatment. Discriminant coefficient showed that the greatest influence on surgical treatment were registred in patients with tumor of Astler-Coller-Dukes stage D (0.255), poorly differentiated adenocarcinoma (histological structure) (0.139), mucynous adenocarcinoma (type of tumor) (0.074) and stage IV according to the TNM elassification (T1-4, N0-2, M1) (0.39). Conclusion. The prognostic factors influencing the outcome of surgery for colorectal carcinoma were defined. Patients with pathohistological finding of Astler-Coller-Dukes stage D, stage IV according to the TNM classification (T1-4, N0-2, M1) and poorly differentiated adenocarcioma have statistically highly significant mortality during the perioperative course of the disease.

Metanephric Adenoma–like Tumors of the Kidney: Report of 3 Malignancies With Emphasis on Discriminating Features

1999 ◽  
Vol 123 (5) ◽  
pp. 415-420 ◽  
Author(s):  
Michael R. Pins ◽  
Edward C. Jones ◽  
E. Vazquez Martul ◽  
Brinda R. Kamat ◽  
Joel Umlas ◽  
...  
Keyword(s):  
Epithelial Membrane Antigen ◽  
Renal Tumor ◽  
Renal Tumors ◽  
Renal Neoplasm ◽  
Metanephric Adenoma ◽  
Pathologic Features ◽  
Potentially Malignant ◽  
Poorly Differentiated ◽  
Dark Staining ◽  
Insular Carcinoma

Abstract Background.—Metanephric adenoma is a very rare benign renal tumor; only 80 well-documented cases have been reported to date. We have seen several renal tumors that were originally incorrectly diagnosed as metanephric adenoma. Design.—We present 3 unusual renal tumors (2 primary and 1 metastatic), each of which illustrates important pathologic features useful in discriminating metanephric adenoma from malignant mimics. Results.—Case 1 involved a 46-year-old man with multiple small, cortical, solid, papillary (chromophil) renal cell carcinomas in his right kidney; the patient developed multiple, histologically identical, solid, papillary (chromophil) carcinomas in the opposite kidney 17 months later. Case 2 involved a 32-year-old woman with a 14-cm right renal tumor who developed soft tissue and bone metastases over a 17-year period. Case 3 involved a 52-year-old woman who presented with a 1.8-cm corticomedullary renal nodule, which eventually proved to represent a metastasis from a poorly differentiated (insular) carcinoma of the thyroid. All 3 tumors superficially resembled metanephric adenoma and consisted of primitive, dark-staining cells arranged in tubules or sheets. Each tumor, however, also had features inconsistent with the diagnosis of metanephric adenoma, including multifocal lesions with a variable nuclear-cytoplasmic ratio and diffuse cytokeratin 7 and epithelial membrane antigen immunopositivity in case 1, a 14-cm-diameter tumor with occasional mitoses in case 2, and a distinct fibrous capsule with capsular and vascular invasion in case 3. In addition, all 3 tumors lacked the cytologic features of bland overlapping nuclei with imperceptible cytoplasm consistently seen in metanephric adenoma. Conclusion.—Adherence to strict histopathologic criteria will discourage misdiagnosis of a malignant or potentially malignant renal neoplasm as the rare and always benign metanephric adenoma.

scholarly journals Kidney tumor radiofrequency ablation progress in Lithuania

2013 ◽  
Vol 12 (3) ◽  
pp. 161-170
Author(s):  
Albertas Ulys ◽  
Algirdas Žalimas ◽  
Rūta Merkytė ◽  
Mantas Trakymas
Keyword(s):  
Radiofrequency Ablation ◽  
Tumor Size ◽  
Renal Tumor ◽  
Radical Surgery ◽  
Malignant Tumors ◽  
Renal Tumors ◽  
The Us ◽  
Vilnius University ◽  
Average Tumor Size

Background / ObjectiveThis retrospective study aimed to clarify one of the minimally invasive therapies – Radiofrequency ablation (RFA) – performance, extremeness and 5-year survival in patients with small renal tumors.Patients and methods118 patients (77 men (65%), and 41 women (35%) with mean age of 68.72 (± 10.12 ) years) were treated with RFA method in Vilnius University Institute of Oncology Urology Section, and since 2003 September 17 till 2012 December 6 were performed144 renal tumor RFAs. All renal tumors RFAs were performed percutaneously in the projection of the skin, under local or general anesthesia. Procedures were performed by one or several small (up to 1 cm) incisions, and in the US control electrodeswere introduced. Since May 2011, 30 RFAs were performed with three electrodes and US control with CT navigation, just a day before the operation additionally titanium markers were put in around the kidney tumor.ResultsSince 2003 till 2007 years our patient’s follow-up method was US examination. However, in case of suspicion of tumor progression, percutaneous renal biopsy and CT were performed. From 2007 year patients were follow-up with CT. The ablationzone, contrast agent accumulation and the ablation of the edge were evaluated. Average tumor size was 2.8 (± 0.9) cm. By histology, mainly there were malignant tumors, much less benign, a minority remained histologically unconfirmed.In our study we found out that the most radical renal tumor RFAs were done in the control of US with CT navigation, when additionally around the renal tumor titanium markers were added. Also we clarified, that procedure is more radical whenperformed using three electrodes. The most common postoperative complication was paranephric hematoma.ConclusionsAfter RFA, 2-year survival rate is 90 %, 5 years – 58%. Death risk factors: tumor size, higher ASA class, non-radical surgery, metastases or other oncologic process.Key words: Radiofrequency ablation, survival, observation, fiducial markers.Inkstų navikų radiodažninės abliacijos pažanga Lietuvoje Įvadas / tikslasMūsų atlikto retrospektyviojo tyrimo tikslas – išsiaiškinti vieno iš minimaliai invazinių gydymo metodų – radiodažninės abliacijos (RDA) efektyvumą, radikalumą ir mažus inkstų navikus turinčių pacientų penkerių metų išgyvenamumą.Ligoniai ir metodai118 pacientų (77 vyrai (65 %) ir 41 moteris (35 %), amžiaus vidurkis 68,72 ± 10,12 metų) buvo gydyti RDA metodu Vilniaus universiteto Onkologijos instituto (VUOI) Urologijos skyriuje. Jiems nuo 2003 m. rugsėjo 17 d. iki 2012 m. gruodžio 6 d. buvo atliktos 144 inkstų navikų RDA. VUOI visos inkstų navikų RDA atliktos perkutaniškai, kai sukėlus vietinę ar bendrąją nejautrą, inksto projekcijos odoje atliekama viena ar kelios nedidelės (iki 1 cm) incizijos, per kurią/kurias kontroliuojant ultragarsu (UG) įkišami elektrodai ir atliekama RDA procedūra. Nuo 2011 m. gegužės 30 d. atliktos RDA su trimis elektrodais, kontroliuojamos ultragarsu su kompiuterinės tomografijos (KT) navigacija, tik dieną prieš operaciją papildomai UG kontroliuojamu būdu suleidus titaninių žymenų (TŽ) aplink inksto naviką.RezultataiMūsų tyrime nuo 2003 m. iki 2007 m. taikytas ultragarsinis ligonių stebėjimo metodas. Įtarus lokalų naviko progresavimą, buvo atliekama perkutaninė inksto biopsija ir KT. Nuo 2007 m. stebėta tik atliekant KT, kurios metu vertinta abliacijos zona, kontrastinės medžiagos (k/m) kaupimas joje ir abliacijos kraštas. Vidutinis naviko dydis buvo 2,8 (± 0,9) cm. Pagal histologiją, daugiausia buvo piktybinių navikų, daug mažiau – gerybinių, mažoji dalis liko histologiškai nepatvirtinta.Radikaliausios inkstų navikų RDA buvo atliktos kontroliuojant UG su KT navigacija ir prieš operaciją UG kontroliuojamu būdu papildomai suleidus aplink naviką titaninių žymenų. RDA yra radikalesnė, kai atliekama naudojant tris elektrodus. Duomenys parodė, kad dažniausia pooperacinė komplikacija buvo paranefrinė hematoma.IšvadosPo RDA procedūros apskaičiuota dvejų metų išgyvenamumo tikimybė – 90 %, penkerių metų – 58 %. Mūsų tyrime nustatyti mirties rizikos veiksniai – naviko dydis, aukštesnė ASA klasė, neradikali operacija, metastazės iš anamnezės, kito organo onkologinis procesas.Reikšminiai žodžiai: radiodažninė abliacija, išgyvenamumas, stebėjimas, titaniniai žymenys.

scholarly journals Vaikų priekinio tarpuplaučio navikų ir displazijų chirurginis

2007 ◽  
Vol 5 (3) ◽  
pp. 0-0
Author(s):  
Stanislovas Jonas Maknavičius ◽  
Benjaminas Siaurusaitis ◽  
Arūnas Valiulis
Keyword(s):  
Surgical Treatment ◽  
Respiratory Distress ◽  
Myasthenia Gravis ◽  
Clinical Symptoms ◽  
Malignant Tumors ◽  
Diagnostic Methods ◽  
Benign Tumors ◽  
Histological Structure ◽  
Malignant Tumours ◽  
Mediastinal Tumours

Stanislovas Jonas Maknavičius, Benjaminas Siaurusaitis, Arūnas ValiulisVilniaus universiteto Vaikų ligoninės Vaikų chirurgijos centras,Santariškių g. 7, LT-08406 VilniusEl paštas: [email protected] Įvadas / tikslas Vaikų priekinio tarpuplaučio navikai ir displazijos yra dažnesni nei plaučių/bronchų navikai. Jie yra embrioninės kilmės, labai įvairios histologinės struktūros. Iki operacijos jų diferencinė diagnostika yra sunki, ji patikslinama atlikus naviko biopsiją ir histologinį tyrimą. Literatūroje diskutuojama dėl operacinio pjūvio, operacijų apimties. Ypač daug neaiškumų yra analizuojant užkrūčio liaukos patologiją. Mūsų tyrimo tikslas – panagrinėti vaikų priekinio tarpuplaučio navikų ir displazijų įvairovę, aptarti diagnostikos ir chirurginio gydymo taktiką. Ligoniai ir metodai Retrospektyviai analizavome 73 vaikų, gydytų 1985–2006 metais Vilniaus universiteto Vaikų ligoninės 1-ajame chirurgijos skyriuje dėl priekinio tarpuplaučio navikų ir displazijų, ligos istorijas, operacijų protokolus, tyrimų duomenis. Ligoniai buvo tirti klinikiniais metodais, atlikti navikinių žymenų tyrimai, acetilcholino antikūnų kiekio tyrimas, rentgenogramos (ir su kontrastuota stemple), kompiuterinės tomogramos, echoskopija, angiogramos, aortogramos. Rezultatai Iš mūsų gydytų ligonių 45-iems nustatyti nepiktybiniai navikai ir displazijos, o 28-iems – piktybiniai navikai. Navikai dažniausiai lokalizavosi užkrūčio liaukoje (48 ligoniams), ne užkrūčio liaukoje (25 ligoniams). Kvėpavimo takų distreso ir kompresijos simptomai buvo 58 ligoniams (79,5%) ir visiems vaikams iki 3 metų. Myasthenia gravis simptomai buvo 11 vaikų, iš jų 7 sirgo sunkia forma. Tiksliai diagnozei nustatyti buvo atliekama naviko biopsija ir histologinis tyrimas. Visos displazijos, nepiktybiniai, solidiniai piktybiniai navikai ir ribotos limfomos pašalinti operaciniu būdu. Šešiems ligoniams, sirgusiems Hodžkino ir ne Hodžkino limfoma, atlikta tik židinio biopsija. Išvados Svarbiausias priekinio tarpuplaučio navikų klinikinis simptomas yra kvėpavimo distresas, rečiau būna karščiavimas ir myasthenia gravis sindromas. Šis sindromas būdingas tikrajai užkrūčio liaukos hiperplazijai, limfoidinei hiperplazijai bei timomoms. Priekinio tarpuplaučio navikai ir displazijos yra labai įvairūs. Diagnozei patikslinti atliekama biopsija ir histologinis tyrimas. Visus nepiktybinius navikus, displazijas, solidinius piktybinius navikus bei ribotas limfomas reikia šalinti tik nustačius diagnozę. Pagrindiniai žodžiai: vaikų priekinio tarpuplaučio navikai, užkrūčio liaukos navikai, chirurginis gydymas Surgical treatment of anterior mediastinal tumours and dysplasias in children Stanislovas Jonas Maknavičius, Benjaminas Siaurusaitis, Arūnas ValiulisVilnius University Children’s Hospital, Centre of the Pediatric Surgery,Santariškių str. 7, LT-08406 Vilnius, LithuaniaE-mail: [email protected] Background / objective Anterior mediastinal tumours and dysplasias are more common than pulmonary – bronchial tumours in children. They differ in histological structure. In children, the differential diagnosis and surgical treatment of mediastinal tumours and dysplasias are very difficult. The aim of this study was to analyse the diagnostic methods of various tumours and dysplasias and the tactics of surgical treatment. Patients and methods We analysed retrospectively 73 children‘s cases histories with anterior mediastinal tumours and dysplasias from the period 1985–2006. Clinical symptoms, histological diagnosis and methods of surgical treatment were analysed. Results Forty-five patients had benign tumors and dysplasias and 28 patients had malignant tumours. Thymic gland pathology was found in 48 patients. Respiratory distress syndrome was have diagnosed in 58 cases (79.5%). All children under 3 years had severe respiratory symptoms. Myasthenia gravis was present in 11 cases. Our data are based on histological analysis after biopsy or operation. All dysplasias, benign tumours, solid malignant tumours and local lymphomas were operated on and removed. Conclusions Anterior mediastinal tumours and dysplasias differed in histological structure. The most frequent symptom was respiratory distress, rare symptoms were fever or myasthenia gravis. All dysplasias, benign and solid malignant tumors and localised lymphomas were operated on and removed when the diagnosis had been confirmed. Keywords: anterior mediastinal tumours in children, thymic gland tumours, surgical treatment

ROLE OF ULTRASOUND IN THE DETECTION OF RECURRENT OVARIAN CANCER

2020 ◽  
Vol 6 (1) ◽  
pp. 23-31
Author(s):  
M. Alisherova ◽  
◽  
M. Ismailova
Keyword(s):  
Ovarian Cancer ◽  
Surgical Treatment ◽  
Reproductive System ◽  
Malignant Tumors ◽  
Recurrent Ovarian Cancer ◽  
Primary Diagnosis ◽  
Female Reproductive System

Currently, there are no standard approaches to monitoring patients with ovarian cancer (OC). While the role of ultrasound (US) has been identified in the primary diagnosis of OS, it is still controversial during the subsequent surgical treatment of OC. In world statistics, ovarian cancer is consistently among the four main localizations of malignant tumors of the female reproductive system, along with tumors of the breast, body and cervix.

HISTOLOGICAL DIAGNOSTICS OF MAMMARY GLAND NEOPLASMS IN CATS

2020 ◽  
Keyword(s):  
Mammary Gland ◽  
Malignant Tumors ◽  
Breast Tumors ◽  
Domestic Animals ◽  
Breast Diseases ◽  
Microscopic Studies ◽  
Malignant Breast ◽  
Poorly Differentiated ◽  
Breast Adenocarcinomas

Mammary gland neoplasms in cats are at the top of the list of the most common nosological diseases among domestic animals; more than half of the tumors appear as malignant. Veterinary practitioners have many questions about the prevalence of breast tumors in cats, depending on age, breed and seasons of the year. The article presents the results of diseases prevalence of benign and malignant breast tumors in cats kept in the conditions of Bishkek. The characteristic of macroscopic and microscopic studies of benign and malignant breast tumors in cats at different periods of life and depending on the breed is also described. Studies were conducted in the period from March 2018 to March 2019. Morphological methods were used in the study of breast tumors. As a result of our research, we established the morphological forms of benign and malignant breast tumors in cats. Among benign neoplastic breast diseases in cats, breast lipoma was observed. Also among the malignant tumors of the breast met highly differentiated, moderately differentiated and poorly differentiated breast adenocarcinomas malnutrition and necrosis as well as the rare phylloid (leaf-shaped) fibroadenoma of the mammary gland which makes up only 0.3-0.5 % of all breast tumors.

scholarly journals Deep learning for end-to-end kidney cancer diagnosis on multi-phase abdominal computed tomography

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Kwang-Hyun Uhm ◽  
Seung-Won Jung ◽  
Moon Hyung Choi ◽  
Hong-Kyu Shin ◽  
Jae-Ik Yoo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Deep Learning ◽  
Kidney Cancer ◽  
Renal Tumor ◽  
Renal Tumors ◽  
Abdominal Computed Tomography ◽  
Wide Range ◽  
End To End ◽  
Multi Phase ◽  
Histologic Subtypes

AbstractIn 2020, it is estimated that 73,750 kidney cancer cases were diagnosed, and 14,830 people died from cancer in the United States. Preoperative multi-phase abdominal computed tomography (CT) is often used for detecting lesions and classifying histologic subtypes of renal tumor to avoid unnecessary biopsy or surgery. However, there exists inter-observer variability due to subtle differences in the imaging features of tumor subtypes, which makes decisions on treatment challenging. While deep learning has been recently applied to the automated diagnosis of renal tumor, classification of a wide range of subtype classes has not been sufficiently studied yet. In this paper, we propose an end-to-end deep learning model for the differential diagnosis of five major histologic subtypes of renal tumors including both benign and malignant tumors on multi-phase CT. Our model is a unified framework to simultaneously identify lesions and classify subtypes for the diagnosis without manual intervention. We trained and tested the model using CT data from 308 patients who underwent nephrectomy for renal tumors. The model achieved an area under the curve (AUC) of 0.889, and outperformed radiologists for most subtypes. We further validated the model on an independent dataset of 184 patients from The Cancer Imaging Archive (TCIA). The AUC for this dataset was 0.855, and the model performed comparably to the radiologists. These results indicate that our model can achieve similar or better diagnostic performance than radiologists in differentiating a wide range of renal tumors on multi-phase CT.

scholarly journals Appendiceal cancer leading to intussusception detected incidentally during follow-up for Peutz–Jeghers syndrome

2020 ◽  
Vol 13 (6) ◽  
pp. 1136-1143
Author(s):  
Kazuhiro Kurihara ◽  
Takanori Suganuma
Keyword(s):  
Malignant Tumors ◽  
Endoscopic Examination ◽  
Autosomal Dominant Disorder ◽  
Tomography Image ◽  
Elevated Lesion ◽  
Poorly Differentiated ◽  
Lower Endoscopy ◽  
Peutz Jeghers Syndrome ◽  
Computed Tomography Image

AbstractPeutz–Jeghers syndrome is an autosomal dominant disorder characterized by hamartomatous polyposis, pigmentation, and malignant tumors. We report a case of ileocecal carcinoma that was incidentally detected during follow-up for Peutz–Jeghers syndrome. A 39-year-old man with solitary Peutz–Jeghers syndrome had undergone three abdominal surgeries. He had been followed up via upper and lower gastrointestinal endoscopy and small intestinal endoscopy. In the endoscopic examination of the lower gastrointestinal tract, a 35 mm large, bumpy, elevated lesion was observed in the cecum. This lesion was not observed 9 months earlier during lower endoscopy. Biopsy of the specimen confirmed tubulovillous adenoma and carcinoma. This lesion was judged to be an indication for operation, and we performed ileocecectomy + D3 lymph node dissection. From the excised specimen, poorly differentiated carcinoma and adenoma components in contact with Peutz–Jeghers-type polyps in the appendix were recognized. A review of the computed tomography image obtained 2 years ago confirmed appendiceal swelling. We suspect that the ileocecal carcinoma in the appendix may have rapidly developed within the 9 months, and was incidentally detected on lower endoscopic examination during follow-up. For the prevention of appendicular tumorigenesis, prophylactic appendectomy may be considered in certain cases during follow-up for Peutz–Jeghers syndrome.

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