Appendiceal neoplasms: Evaluation of 4761 appendectomy specimens
Appendiceal neoplasms: Evaluation of 4761 appendectomy specimens
Acute appendicitis is the most diagnosed intraabdominal pathology in emergency surgery meanwhile appendiceal neoplasms are infrequent and mostly detected in postoperative pathological work-up. In this study, we aimed to identify the incidence of appendiceal neoplasms and histopathological distribution of appendectomy specimens of our patients operated with the diagnosis of acute appendicitis. Between January 2010 and December 2020 postoperative results of patients who were operated with the diagnosis of acute appendicitis in a tertiary hospital were evaluated. Appendiceal neoplasms and subtypes of neoplasms according to pathology specimens are noted and long-term results of patients diagnosed with malignancy are given. 4761 patients operated for acute appendicitis while 55 (1.1%) of them had neoplasms on postoperative pathological evaluation. Eighteen out of 55 patients (32.7%) there were neuroendocrine tumor and in 36 patients there were mucinous lesions with different grades. Lowgrade appendiceal mucinous neoplasms were the most common mucinous lesions. No statistically difference in terms of age and sex between group1 (patients who had appendicitis) and group 2 (patients who had neoplasm). Acute appendicitis is an emergent situation where the routine histopathological examination of specimens should be carefully performed to rule out malignancy.
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- 1. Körner H, Söndenaa K, Söreide JA, et al. Incidence of acute nonperforated and perforated appendicitis: age-specific and sex-specific analysis. World J Surg. 1997;21:313–7.
- 2. Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986;15:557–64.
- 3. Andersson M, Andersson RE. The Appendicitis Inflammatory Response Score: A Tool for the Diagnosis of Acute Appendicitis that Outperforms the Alvarado Score. World J Surg. 2008;32:1843–9.
- 4. Unver N, Coban G, Arıcı DS, et al. Unusual histopathological findings in appendectomy specimens: a retrospective analysis of 2047 Cases. Int J Surg Pathol. 2019;27:142–6.
- 5. Bhangu A, Søreide K, Di Saverio S, et al. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet. 2015;386:1278–87.
- 6. Wilms IM, Hoog DE de, Visser DC de, Janzing HM. Appendectomy versus antibiotic treatment for acute appendicitis. Cochrane Database Syst Rev. Published Online First: 2011.
- 7. Mällinen J, Vaarala S, Mäkinen M, et al. Appendicolith appendicitis is clinically complicated acute appendicitis—is it histopathologically different from uncomplicated acute appendicitis. Int J Colorectal Dis. 2019;34:1393– 400.
- 8. Buckius MT, McGrath B, Monk J, et al. Changing epidemiology of acute appendicitis in the united states: study period 1993–2008. J Surg Res. 2012;175:185–90.
- 9. Petroianu A, Barroso TVV. Pathophysiology of acute appendicitis. Published Online First: 2016.
- 10. AlHarmi RAR, Almahari SA, AlAradi J, et al. Seasonal variation in cases of acute appendicitis. Surg Res Pract. 2021;2021:e8811898.
- 11. Al-Abed YA, Alobaid N, Myint F. Diagnostic markers in acute appendicitis. Am J Surg. 2015;209:1043–7.
- 12. Luiz do Nascimento Junior P, Teixeira Brandt C, Petroianu A. Differences between inflamed and non inflamed appendices diagnosed as acute appendicitis. Ann Med Surg. 2021;62:135–9.
- 13. Whittle C, Pérez L, Cortes M, et al. Appendicular lymphoid hyperplasia in the differential diagnosis of acute appendicitis: sonographic findings. J Diagn Med Sonogr. 2020;36:19–23.
- 14. Shahmoradi MK, Zarei F, Beiranvand M, Hosseinnia Z. A retrospective descriptive study based on etiology of appendicitis among patients undergoing appendectomy. Int J Surg Open. 2021,31:100326.
- 15. Bahmad HF, Aljamal AA, Alvarez Moreno JC, et al. Rising incidence of appendiceal neoplasms over time: Does pathological handling of appendectomy specimens play a role? Ann Diagn Pathol. 2021;52:151724.
- 16. Kunduz E, Bektasoglu HK, Unver N, et al. Analysis of appendiceal neoplasms on 3544 appendectomy specimens for acute appendicitis: retrospective cohort study of a single institution. Med Sci Monit Int Med J Exp Clin Res. 2018;24:4421–6.
- 17. Shannon AB, Song Y, Roses RE, et al. National trends in the presentation of surgically resected appendiceal adenocarcinoma over a decade. J Surg Oncol. 2021;123:606–13.
- 18. Ozer MT, Demirbas S, Celik E, et al. Natural behaviour and surgical treatment of appendiceal carcinoids: an analysis of 2,376 consecutive emergency appendectomies. Bratisl Lek Listy. 2011;112:619–22.
- 19. Temi̇z A, Albayrak Y, Özmen SA. Carcinoid tumor of appendix: evaluatıon of 3981 appendectomy cases. Bozok Tıp Derg. 2018;8:1–4.
- 20. Keutgen XM, Vaghaiwalla TM. Surgical Evaluation of Appendiceal Neuroendocrine Tumors. In: Cloyd JM, Pawlik TM, eds. Neuroendocrine Tumors: Surgical Evaluation and Management. Springer International Publishing: Cham; 2021;191–206.
- 21. Kaderli RM, Perren A, Zwahlen M. Distant metastases and long-term survival after complete resection of neuroendocrine tumors of the appendix: An International Multicenter Study (SurvivApp).
- 22. Villa M, Sforza D, Siragusa L, et al. A low-grade appendiceal mucinous neoplasia and neuroendocrine appendiceal collision tumor: a case report and review of the literature. Am J Case Rep. 2021;22:e927876-1-e927876-6.
- 23. Soni TP, Sharma P, Sharma A, Ledwani N. Low-grade mucinous appendiceal neoplasm: a tumor in disguise of appendicitis. J Gastrointest Cancer. Published Online First: 11 February 2021.
- 24. Gong Y, Wang HL, Tatishchev S. Appendiceal Diseases. In: Wang HL, Chen ZE, eds. Practical Gastrointestinal Pathology: Frequently Asked Questions. Springer International Publishing: Cham; 2021;167–94.