腹部腫瘤を主訴とした虫垂結石の一例

虫垂結石は虫垂炎手術例の数％に見られるに過ぎないが，穿孔性腹膜炎などの重篤な炎症を招く可能性が高いことで知られている。自験例は41才の女性で，右下腹部腫瘤を主訴として来院した。画像診断で腫瘤は虫垂に連続し，内部に石灰化を認めたが，腫瘤が硬く，虫垂炎症状が軽微であったことから，虫垂原発腫瘍を疑い手術を行ったところ，虫垂膿瘍を併発した虫垂結石であった。本症が自験例のように触知可能な腹部腫瘤を形成することは比較的まれである。

Appendiceal calculi are found in the only several percent of patients with appendicitis and have been known to be complicated in severe appendicitis or perforated peritonitis. We reported a 41-year-old female patient, whose initial symptom was right lower abdominal tumor of insidious growing. Abdominal examination revealed a small fist sized hard mass in the right lower abdomen with slight tenderness, and free of rebound tenderness and muscle defence. Abdominal ultrasonography and computed tomography showed that the tumor had continuity with appendix and contained calcification inside. Accordingly, she was diagnosed to have an appendiceal neoplasm and operated on. Post-operative diagnosis was appendiceal abscess with a calculus, 1 centimeter in diameter. It is rare that appendiceal calculi manifest a palpable abdominal tumor like this case.