SummaryDespite the fact that the appendix is one of the rarest anatomic localization of neuroendocrine tumours (NETs) in the digestive system, the appendicular neuroendocrine tumour (A-NET) remains among the most common tumours of the appendix. The A-NET usually presents as a small solitary lesion revealed only after pathological examination of appendix that has been surgically removed for acute appendicitis. Only 18 papers in the Pubmed database are dedicated to A-NET in pregnancy. Here we present a well-documented case of A-NET in a pregnant lady. Key words: pregnancy, appendix, neuroendocrine tumour.
CASE REPORT
Neuroendocrine Tumour of the Appendix in PregnancyAndrejs Vanags*,**, Ilze Strumfa*, Zane Simtniece*, Jānis Gardovskis*,** *Riga Stradins University, Latvia **Pauls Stradins Clinical University Hospital, Riga, Latvia
AIM OF THE DEMONSTRATIONWe present thoroughly documented case of A-NET of the appendix in a pregnant female in order to demonstrate a rare tumour in an unusual clinical setting.
CASE REPORTA 24-year-old female with progressive 2 nd pregnancy of 35 weeks was admitted to the hospital due to dull pain in the epigastrium. There was no evidence of previous similar episodes. The ultrasonography (US) revealed slightly enlarged spleen reaching 14x4.7 cm as the only abnormality. By foetal US, foetus corresponded to the gestational age of 34 weeks and 4 days. The laboratory investigations demonstrated low haemoglobin level 117 g/L [laboratory reference interval 131-175 g/L] and increased white blood cell (WBC) count 12.9 x10 9 /L [4.0-9.8x10 9 /L]. A surgeon consulted patient on the same day. Progressive pain in the lower part of abdomen was established by the second visit of surgeon on the next morning; a diarrhoea episode was also revealed. C-reactive protein (CRP) level was progressively increasing from 7.5 mg/L to 58.7 mg/L [0-5.0 mg/L]. The indications for appendectomy were set up and the operation was performed by the McBurney laparotomy approach. No specific local findings were found during the exploration of the abdominal cavity. The appendix was compressed by the uterus; it was located behind the caecum. No palpable mass and no peritoneal fluid was revealed during the laparotomy. However, the apex of the appendix visually was slightly enlarged and the appendix was removed. The wound healed by primary intention without any local or general complications. After the operation, CRP level decreased to 19.5 mg/L and WBC count regressed to 5.4 x10 9