Appendiceal Neoplasms

Appendiceal adenocarcinoma found by surgery for acute appendicitis is associated with older age

BMC Surgery ◽

10.1186/s12893-021-01224-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

John P. Skendelas ◽

Victor S. Alemany ◽

Vincent Au ◽

Devika Rao ◽

John McNelis ◽

...

Keyword(s):

New York ◽

Acute Appendicitis ◽

Incidental Finding ◽

Population Sample ◽

Operative Therapy ◽

Operative Management ◽

The United States ◽

Improvement Program ◽

Common Procedure ◽

Appendiceal Neoplasms

Abstract Background Appendectomy for acute appendicitis is the most common procedure performed emergently by general surgeons in the United States. The current management of acute appendicitis is increasingly controversial as non-operative management gains favor. Although rare, appendiceal neoplasms are often found as an incidental finding in the setting of appendectomy. Criteria and screening for appendiceal neoplasms are not standardized among surgical societies. Methods The National Surgical Quality Improvement Program (NSQIP) database was queried for all patients who underwent appendectomy over a 9-year period (2010–2018). Over the same time period, patients who underwent appendectomy in two municipal hospitals in The Bronx, New York City, USA were reviewed. Results We found a 1.7% incidence of appendiceal neoplasms locally and a 0.53% incidence of appendiceal tumors in a national population sample. Both groups demonstrated an increased incidence of appendiceal carcinoma by age. This finding was most pronounced after the age of 40 in both local and national populations. In our study, the incidence of appendiceal tumors increased with each decade interval up to the age of 80 and peaked at 2.1% in patients between 70 and 79 years. Conclusions Appendiceal adenocarcinomas were identified in patients with acute appendicitis that seem to be associated with increasing age. The presence of an appendiceal malignancy should be considered in the management of older patients with acute appendicitis before a decision to embark on non-operative therapy.

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A retrospective analysis and literature review of neoplastic appendiceal mucinous lesions

BMC Surgery ◽

10.1186/s12893-021-01091-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Belén Matias-García ◽

Fernando Mendoza-Moreno ◽

Ana Blasco-Martínez ◽

José Ignacio Busteros-Moraza ◽

Manuel Diez-Alonso ◽

...

Keyword(s):

Computed Tomography ◽

Abdominal Pain ◽

Surgical Technique ◽

Clinical Status ◽

Chronic Abdominal Pain ◽

Tumour Type ◽

Appendiceal Neoplasm ◽

Appendiceal Neoplasms ◽

Statistical Program ◽

The Subject

Abstract Background At present, the term mucocele is outdated, and mucinous appendiceal neoplasm is preferred. Mucinous appendiceal neoplasm is an uncommon pathology that occurs predominantly in middle-aged women. Its classification and management have been the subject of debate in recent decades. The aim of this study was to analyse the incidence, clinical management and survival of these tumours diagnosed in our centre in the last 10 years. Methods This was a retrospective observational study of patients with a diagnosis of appendiceal neoplasms between 2009 and 2018 in our centre. Variables such as sex, age, tumour type, clinical status, diagnosis, treatment and survival were collected. All data were analysed using the statistical program IBM SPSS Statistic® version 25. Results Twenty-nine patients with a diagnosis of appendiceal neoplasm were identified, and 24 corresponded to neoplastic appendiceal mucinous lesions (85.7%). The average age was 59.7 ± 17.6 years. Most patients were women (15 cases; 62.5%). Most of them presented with chronic abdominal pain (37.5%), and the diagnosis was performed by computed tomography (CT) (50%). The treatment was surgical in all cases. The surgical technique depended on the findings and histology of the tumour. Conclusion Mucinous appendiceal neoplasms are an uncommon entity, and their pathological classification and management have recently changed.

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Significance of acquired diverticular disease of the vermiform appendix: a marker of regional neoplasms?

Journal of Clinical Pathology ◽

10.1136/jclinpath-2011-200647 ◽

2012 ◽

Vol 65 (7) ◽

pp. 638-642 ◽

Cited By ~ 14

Author(s):

Klaus Kallenbach ◽

Sofie Vetli Hjorth ◽

Ulla Engel ◽

Nis Hallundbæk Schlesinger ◽

Susanne Holck

Keyword(s):

Diverticular Disease ◽

Vermiform Appendix ◽

Diagnostic Process ◽

Pathology Report ◽

Colorectal Carcinomas ◽

Valuable Contribution ◽

Appendiceal Neoplasms ◽

Neoplastic Lesions ◽

Putative Marker ◽

Space Occupying Lesion

AimTo assess the prevalence of acquired diverticulum of the appendix (DA), including incipient forms and its possible significance as a marker of local/regional neoplasms.Materials and MethodsThe pathology database at Hvidovre Hospital was searched for appendix specimens, received between 2001 and 2010, coded for DA or for a space-occupying lesion. Slides were reviewed to determine DA status and the nature of lesions possibly causing DA.ResultAmong 4413 appendix specimens, DA were identified in 39 (0.9%, CI 0.6% to 1.2%) cases, 17 (43.6%, 28.0% to 59.2%) of which additionally harboured an appendiceal neoplasm/neoplastic precursor, whereas this figure was 1.2% (CI 0.9% to 1.6%) for non-DA specimens (p<0.0001). Six of the 39 DA specimens comprised incipient DA, three of which coexisted with appendiceal neoplasms. In addition, local/regional non-neoplastic lesions (six cases) and colorectal carcinomas (four cases) coexisted with DA.ConclusionDA has significance as a putative marker of local/regional neoplasms. Therefore, a DA specimen proved significantly more likely to harbour a neoplastic growth than a non-DA counterpart. Submission for microscopy of the entire DA specimen, whether transmural or only incipient, and a comment in the pathology report on the occasional concurrence of local/regional neoplasms in this setting seem appropriate. The observation of DA may thus provide a valuable contribution in the diagnostic process.

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Misdiagnosis of appendiceal neoplasms as ovarian tumors: Impact of prior gynecologic surgery on definitive cytoreduction and HIPEC

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2021.08.022 ◽

2021 ◽

Author(s):

Mary Garland- Kledzik ◽

Shelley Maithel ◽

Mehraneh D. Jafari ◽

Farideh Dehkordi-Vakil ◽

Haris Chaudhry ◽

...

Keyword(s):

Ovarian Tumors ◽

Gynecologic Surgery ◽

Appendiceal Neoplasms

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Appendiceal Carcinoids In Crohn’s Disease

Canadian Journal of Gastroenterology ◽

10.1155/2003/625368 ◽

2003 ◽

Vol 17 (1) ◽

pp. 43-46 ◽

Cited By ~ 17

Author(s):

Hugh J Freeman

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Carcinoid Tumour ◽

Intestinal Resection ◽

Case Review ◽

Appendiceal Neoplasms ◽

Increased Risk ◽

Intestinal Neoplasms ◽

Resection Specimen ◽

Sporadic Cases

Earlier investigations demonstrate an increased risk for colon cancer in Crohn's disease. For other intestinal neoplasms, such as carcinoids, studies are limited. In Crohn's disease, repeated endoscopic and imaging studies along with intestinal resections may facilitate clinical recognition of neoplastic diseases, including appendiceal neoplasms. To date, however, only sporadic cases of appendiceal carcinoids have been described in Crohn's disease. In the present study, in a single clinician database of 1000 Crohn's disease patients, three of the 441 patients who had undergone intestinal resection had appendiceal carcinoids, all of which were pathologically confirmed. All were observed in female patients and were not suspected before surgical treatment. In one case, even though management was not altered, the tumour had already invaded serosal fat indicating a potential for more advanced disease. In this series, a carcinoid tumour was found in a resection specimen during a later clinical case review and another was a microcarcinoid, implying that these tumours may be overlooked in Crohn's disease. The percentage detected in the entire database (0.3%) exceeds the reported rates of detection of appendiceal carcinoids after removal of the appendix for appendicitis, as well as the rate of detection of appendiceal carcinoids in autopsy studies. This percentage would be higher if only those having an intestinal resection were considered (0.68%). Additional studies are needed to further define this risk of appendiceal carcinoids in Crohn's disease.

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Retrospective analysis of the appendiceal neoplasms: sampling technique may influence neoplasm detection

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2021-141244 ◽

2021 ◽

pp. postgradmedj-2021-141244

Author(s):

Gizem Issin ◽

Fatih Demir ◽

Hasan Aktug Simsek ◽

Diren Vuslat Cagatay ◽

Mahir Tayfur ◽

...

Keyword(s):

Retrospective Analysis ◽

Distal Part ◽

Histopathological Examination ◽

Small Diameter ◽

Sampling Technique ◽

Proximal Part ◽

Longitudinal Section ◽

Appendiceal Neoplasms ◽

Macroscopic Findings ◽

Distal Section

Background and aimsAppendiceal neoplasms are uncommon entities that are usually determined incidentally during the histopathological examination. Different techniques used for the macroscopic sampling of appendectomy material may affect the determinating neoplasms.Materials and methodsH&E-stained slides of 1280 cases who underwent appendectomy between 2013 and 2018 were reviewed retrospectively for histopathological features.ResultsNeoplasms were determined in 28 cases (3.09%); 1 lesion was observed in the proximal part of the appendix, 1 covering the entire length from proximal to distal and 26 in the distal part. In the 26 cases that observed in the distal part, the lesion was seen on both sides of the longitudinal section of the distal appendix in 20 cases, while it was seen on only one distal longitudinal section in the remaining 6 cases.ConclusionThe vast majority of appendiceal neoplasms are seen in the distal part of the appendix, and, in some cases, neoplasms might be seen on only one side of the distal section. Sampling only one-half of the distal part of the appendix, where tumours are most often observed, could result in some neoplasms being missed. Therefore, sampling the whole distal part would be more beneficial to determine small diameter tumours that do not create macroscopic findings.

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