摘要
目的探讨肛周佩吉特病并直肠中分化腺癌伴黏液腺癌的临床特点。方法回顾性分析我院收治的肛周佩吉特病并直肠中分化腺癌伴黏液腺癌1例的临床资料。结果本例因肛门肿物脱出1年入院。曾在当地医院就诊,考虑乳腺外佩吉特病。查体:外阴皮肤完好,未见皮疹,肛周可见环周菜花样肿物,质韧,表面呈颗粒状,有少量分泌物,肛门指检触及肛周右侧肿物上缘延伸至齿状线上2 cm。完善盆腔MRI、活组织病理检查,于气管插管全身麻醉下行腹腔镜肿物直肠肛管根治性切除伴结肠造口术,结合术中所见及病理结果,确诊为肛周佩吉特病并直肠中分化腺癌伴黏液腺癌,术后予化疗,症状好转出院。随访8个月,病情未复发。结论肛周佩吉特病并直肠中分化腺癌伴黏液腺癌临床少见,及时行组织病理检查有助于早期确诊。
Objective To investigate clinical characteristics of perianal Paget disease(PPD)combined with rectal moderately differentiated adenocarcinoma associated by mucinous adenocarcinoma.Methods Clinical data of a patient with PPD combined with rectal moderately differentiated adenocarcinoma associated by mucinous adenocarcinoma was retrospectively analyzed.Results The patient was referred to our hospital because of prolapse of anus neoplasm for 1 year.Physical examination performed at a local hospital identified extramammary Paget's disease.Physical examination showed intact vulva skin without rash,and cauliflower-like neoplasm around the anal with toughness,granular surface and a small amount of secretions.Upper edge of neoplasm at the right side of perianal area was 2 cm to the dentate line by digital rectal examination.After pelvic magnetic resonance imaging(MRI)examination and pathological examination of living tissues,we performed laparoscopic radical excision of rectum and anal tube associated with colostomy under tracheal cannula and general anesthesia.The patient was confirmed as having PPD combined with rectal moderately differentiated adenocarcinoma associated by mucinous adenocarcinoma according to intraoperative findings and pathological results.The patient was discharged after symptoms had been improved by postoperative chemotherapy.No recurrence was found during follow-up for 8 months.Conclusion PPD combined with rectal moderately differentiated adenocarcinoma associated by mucinous adenocarcinoma is rare in clinical settings,and timely histopathologic examination should be performed for early diagnosis.
作者
莫丽平
张思奋
陈诗伟
MO Li-ping;ZHANG Si-fen;CHEN Shi-wei(The Second Clinical Medical College,Guangzhou University of Chinese Medicine,Guangzhou 510120,China;Department of Proctology,Traditional Chinese Medicine Hospital of Guangdong Province,Guangzhou 510120,China))
出处
《临床误诊误治》
2018年第3期20-22,共3页
Clinical Misdiagnosis & Mistherapy
关键词
佩吉特病
乳腺外
直肠肿瘤
腺癌
黏液
漏诊
Paget disease,extramammary
Rectal neoplasms
Adenocarcinoma,mucinous
Missed diagnosis
作者简介
通讯作者:张思奋,E-mail:nzhangsf@163.com
