虫垂粘液嚢胞腺癌の5例

We report five cases, two in detail, of mucinous cystadenocarcinoma of the appendix vermiformis.Case 1 : A 46-year-old woman undergoing surgical resection for suspected acute appendicitiswas found to have an enlarged appendix and intraabdominal pooling of mucin. Appendectomywith partial cecectomy was done, but the postoperative histological diagnosis was a mucinous cystadenocarcinoma of the appendix, necessitating ileocecal resection. Follow-up CT 7 months afterinitial operation showed a recurrent intraperitoneal tumor, which was then resected. She underwentintraperitoneal CDDP chemotherapy via a reservoir, and no symptom of recurrence has beenfound since. Case 2 : A 59-year-old woman undergoing ileocecal resection for appendiceal mucocelewas found 6 months later to have a metastatic liver tumor. Systemic chemotherapy markedlyreduced it, and intraabdominal CDDP chemotherapy instituted postoperatively has shown nosymptom of intraabdominal recurrence. From these results and three other cases, we considerthat adequate surgical resection and the removal of intraabdominal pooling of mucin and irrigationtogether can provide a good prognosis. Intraperitoneal CDDP chemotherapy is also useful ininhibiting the recurrence of pseudomyxoma peritonei.