Unusual Presentation of Appendiceal Adenocarcinoma: Report of a Case

闌尾腺癌之罕見表現：病例報告

10.29833/FJS.200810.0005

劉憲(Hsien Liu)；袁行修(Shyng-Shiou Yuan)；林愷仁(Kai-Jen Lin)；黃致錕(Chih-Kun Huang)；洪朝明(Chao-Ming Hung)；陳耀林(Yaw-Sen Chen)

Sister Mary Joseph nodule ； umbilical metastasis ； appendiceal neoplasm

Formosan Journal of Surgery

41卷5期（2008 / 10 / 01）

217 - 220

英文

瑪麗喬瑟夫結爲腹腔內惡性腫瘤轉移至肚臍皮膚之少見病徵，通常表示疾病預後不佳。 在此我們提出一病例，其闌尾腺癌以瑪麗喬瑟夫結爲首發之病徵。患者爲一名51歲女性，因臍部有分泌物長達一個月而到院治療，無其他腸胃道症狀。 理學檢查發現臍部有一堅硬無壓痛之紅色結節併有黏液分泌物，其切片檢查爲腺癌。經進一步之影像檢查及剖腹探查，証實爲闌尾腺癌併子宮及右側卵巢轉移，回顧相關文獻並無發現闌尾腺癌以瑪麗喬瑟夫結爲首發病徵之病例。 本文作者除強調臨床上此病徵詳細檢查之重要性外，亦對相關文獻做一回顧。

Sister Mary Joseph's nodule, which can present as the first sign of internal malignancies, is a rare form of cutaneous umbilical metastases and usually carries a poor prognosis. A case of Sister Mary Joseph’s nodule caused by primary appendiceal adenocarcinoma is presented. A 51-year-old female patient was with umbilical discharge for one month. No other gastrointestinal symptoms was noted. Physical examination revealed a hard, non-tender umbilical nodule with skin discoloration and mucus-like discharge. Histopathologic examination of the umbilical biopsy specimen revealed a mucin-producing, well-differentiated adenocarcinoma. The primary lesion proved to be appendiceal adenocarcinoma with invasion to right adnexa and uterus via further image study and exploratory laparotomy. To the best of our knowledge, the case we present is the first reported appendiceal adenocarcinoma with umbilical metastasis. The authors emphasize the need for careful evaluation of any umbilical lesions and the importance of histologic diagnosis when the origin of the diseases is undetermined.