Clinical Retrospective Analysis Of 14 Cases Of Primary Appendic Malignant Tumor

Objective Combined with primary malignant tumor of appendix?PMTA?epidemiological characteristics,based on specific cases to explore its clinical manifestations,diagnostic analysis and treatment,with a view to the future clinical work of primary appendicitis provide help.Methods A retrospective analysis was made on the surgical treatment of 14 cases of PMTA in the Department of general surgery of the Second Affiliated Hospital of Dalian Medical University from January 2012 to December 2016.Results1.General data: In 14 cases of PMTA patients,the ratio of male to female was1.33:1?8:6?,with age ranging 21 to 76 years old,with an average age of 53 years old.2.The clinical manifestation: In 14 cases of PMTA patients,the patients' number with metastatic lower abdominal pain is 7 cases as initial symptom,intermittent or repeated abdominal pain is 5 cases as the main symptom,and right lower abdominal mass is 2 cases.3.Auxiliary examination: Hematology examination in 14 cases of PMTA showed white blood cell count?WBC?elevated in 8 cases,?11¹7?×10 9 /L,and normal in 6cases,?11¹7?×109/L.Carcino-embryonic antigen?CEA?: 10 cases were not found,and 2 cases were normal.In 2 cases,it were increased?16.13ng/ml and 25.92ng/ml?;Imageological examination: 14 cases underwent abdominal Doppler ultrasound,out of which,10 cases had echo-free liquid dark area,3 cases had mixed echo area,and 1 case had ascites;Abdominal multislice CT was done in 9 cases: enlargement of the appendix and lymph nodes around the small shadow in 6 cases,right lower quadrant abdominal cystic low density shadow in 3 patients;X-ray barium enema in 1 case,did not see obvious exception;Colonoscopy in 1 case,appendix opening small ulcers.4.The pathological type and AJCC?American Joint Committee on Cancer?staging of cancer: In 14 cases of primary appendix tumor patients,including carcinoid appendix 4 cases?28.6%?;adenocarcinoma of the appendix neonatal ileoileocolic intussusception led by a 7 cases?50.0%?;The appendix mucous adenocarcinoma in 3patients?21.4%?.In 14 cases of primary appendix tumor patients,4 cases of appendiceal carcinoid,1 case of T₁aN₀M₀,2 cases of T₁bN₀M₀,1 case of T₂N₁M₀;7 cases of appendiceal adenocarcinoma,of which 3 cases of T₂N₀M₀,3 cases of T₃N₁M₀,1 case of T₄N₂M1;3 cases of appendix mucinous adenocarcinoma,1 case of T₃N₁M₀,2 cases of T₄N₂M₀.5.Treatment: In 14 cases of primary appendix tumor patients,13 underwent surgical treatment,1 case because of whole body movement signs without surgery.Surgical treatment of appendix resection only 4 cases?30.8%?.Stage ? appendectomy+ ? blind back part resection in 2 cases?15.4%?;Stage ? appendectomy + ? radical right half colon resection in 3 cases?23.1%?.Stage ? appendectomy + ? Laparoscopic right hemicolectomy in 1 cases?7.6%?.1 case of appendectomy for suspected appendiceal neoplasms following frozen pathology underwent radical resection of the right colon?7.6%?;2 cases of right lower abdominal mass after radical resection of the right colon were considered malignant?15.4%?.Conclusion Primary appendix malignant tumor preoperative diagnosis is difficult,often in the surgery and postoperative pathology found.Surgical choice should be based on the location of the appendix tumor,size and general circumstances,if necessary,supplemented by chemotherapy and other comprehensive treatment.