Hacer DEMİR, Fatma ŞENEL, Hatice KARAMAN

Neuroendocrine tumors detected in appendectomy specimens: ten-year single-center experience

Background/aim: The aim of this study was to investigate neuroendocrine tumors (NETs) detected in appendectomy specimens andthe incidence and clinicopathologic characteristics of these tumors in our center.Materials and methods: A total of 13,863 patients were evaluated retrospectively. All underwent appendectomy operation in the KayseriTraining and Research Hospital and had a histopathological examination at the Pathology Clinic between January 2007 and March 2017.Age, sex, preoperative clinical findings, operation procedure, and histopathological examination results of the cases reported to be NETare presented.Results: NET was detected in 29 cases (0.2%) in the histopathological examination of 13,863 appendectomy specimens. Of these, 26were classical carcinoid tumors and 3 were goblet cell carcinoid tumors (GCCTs). For the NET cases, the mean age was 37 years and themale to female ratio was 1.07. Only 68.9% of the patients underwent an appendectomy, and 31% of the patients underwent a secondaryright hemicolectomy. Recurrences were not detected in any of the cases. In the present study, coincidence was determined in all of thecases with NET in the appendix.Conclusion: Contrary to many studies, both NETs of the appendix and GCCT cases were slightly higher among males and advanced agegroups in this study. The long-term life expectancy in cases of classical carcinoid tumors of the appendix is quite good.

PDF

___

Pinchot SN, Holen K, Sippel RS, Chen H. Carcinoid tumors. Oncologist 2008; 13: 1255-1269.
Bernick PE, Klimstra DS, Shia J, Minsky B, Saltz L, Shi W, Thaler H, Guillem J, Paty P, Cohen AM et al. Neuroendocrine carcinoma of the colon and rectum. Dis Colon Rectum 2006; 47: 163-169.
Estrozi B, Bacchi CE. Neuroendocrine tumors involving the gastroenteropancreatic tract: a clinicopathological evaluation of 773 cases. Clinics 2011; 66: 1671-1675.
Maggard MA, O’Connell JB, Ko CY. Updated population-based review of carcinoid tumors. Ann Surg 2004; 240: 117-122.
Gustafsson BI, Kidd M, Modlin IM. Neuroendocrine tumors of the diffuse neuroendocrine system. Curr Opin Oncol 2008; 20: 1-12.
Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer 2003; 97: 934-959.
Rosai J. Appendix. In: Rosai and Ackerman’s Surgical Pathology. 10th ed. Edinburgh, UK: Elsevier; 2011. pp. 714.
Bosman F, Carneiro F, Hruban R, Theise N, editors. WHO Classification of Tumours of the Digestive System. Lyon, France: IARC Press; 2010.
Doyle LA, Odze RW. Inflammatory disorders of the appendix. In: Odze RD, Goldblum JR, editors. Surgical Pathology of the GI Tract, Liver, Biliary Tract and Pancreas. 2nd ed. Philadelphia, PA, USA: Elsevier; 2015. pp. 512-529.
Paşaoğlu E. Apendiksin tümörleri. In: Doğusoy G, editor. Gastroenteroloji Patoloji. İzmir, Turkey: O’Tıp Kitabevi ve Yayıncılık; 2015. pp. 240-259 (in Turkish).
Ruoff C, Hanna L, Zhi W, Shahzad G, Gotlieb V, Saif MW. Cancers of appendix: review of the literatures. ISRN Oncology 2011; 2011: 728579.
Gosset A, Masson P. Tumeurs endocinne de l’appendice. La Presse Medicale 1914; 22: 237-240 (in French).
Zvizdić Z, Đuran A, Karavdić K, Jakić A, Milišić E. Carcinoid tumors of the appendix vermiform in children-ten year analysis of 1503 appendectomies. BH Surgery 2011; 1: 100-103.
Barreto SG, Tiong L, Thomas T, Travers E, Williams RS. Incidental appendiceal carcinoids: is surgery affecting their incidence? World J Oncol 2012; 3: 227-230.
Goede AC, Caplin ME, Winslet MC. Carcinoid tumour of the appendix. Br J Surg 2003; 90: 1317-1322.
McGory ML, Maggard MA, Kang H, O’Connell JB, Ko CY. Malignancies of the appendix: beyond case series reports. Dis Colon Rectum 2005; 48: 2264-2271.
Gramlich J, Petras R. Vermiform appendix. In: Mills S, editor. Histology for Pathologists. Philadelphia, PA, USA: Lippincott Williams; 2007. pp. 648-657.
Pham TH, Wolff B, Abraham SC, Drelichman E. Surgical and chemotherapy treatment outcomes of goblet cell carcinoid: a tertiary cancer center experience. Ann Surg Oncol 2006; 13: 370-376.
O’Donnell ME, Carson J, Garstin WI. Surgical treatment of malignant carcinoid tumours of the appendix. Int J Clin Pract 2007; 61: 431-437.
Alsaad KO, Serra S, Schmitt A, Perren A, Chetty R. Cytokeratins 7 and 20 immunoexpression profile in goblet cell and classical carcinoids of appendix. Endocr Pathol 2007; 18: 16-22.
Vilchez RT, Martin DP, Blanco CQ, Aragones AM, Liebana RF, Donoso FJM, Conejo EA. Goblet cell carcinoid of the appendix. A 52 years old male with acute appendicitis. Oncologia 2007; 30: 72-75.
Hemminki K, Li X. Incidence trends and risk factors of carcinoid tumors: a nationwide epidemiologic study from Sweden. Cancer 2001; 92: 2204-2210.
Debnath D, Rees J, Myint F. Are we missing diagnostic opportunities in cases of carcinoid tumours of the appendix? Surgeon 2008; 6: 266-272.
Moertel CG, Weiland LH, Nagorney DM, Dockerty MB. Carcinoid tumor of the appendix: treatment and prognosis. N Engl J Med 1987; 317: 1699-1701.
Moertel CG. Treatment of the carcinoid tumor and the malignant carcinoid syndrome. J Clin Oncol 1983; 1: 727-740.
Tang LH, Shia J, Soslow RA, Dhall D, Wong WD, O’Reilly E, Qin J, Paty P, Weiser MR, Guillem J et al. Pathologic classification and clinical behavior of the spectrum of goblet cell carcinoid tumors of the appendix. Am J Surg Pathol 2008; 32: 1429-1443.
Shenoy S. Goblet cell carcinoids of the appendix: tumor biology, mutations and management strategies. World J Gastrointest Surg 2016; 8: 660-669.
Pape UF, Perren A, Niederle B, Gross D, Gress T, Costa F, Arnold R, Denecke T, Plöckinger U, Salazar R et al. ENETS Consensus Guidelines for the management of patients with neuroendocrine neoplasms from the jejuno-ileum and the appendix including goblet cell carcinomas. Neuroendocrinology 2012; 95: 135- 156.
Modlin IM, Sandor A. An analysis of 8305 cases of carcinoid tumors. Cancer 1997; 79: 813-829. 30. Pahlavan PS, Kanthan R. Goblet cell carcinoid of the appendix. World J Surg Oncol 2005; 3: 36.
O’Connell JT, Tomlinson JS, Roberts AA, McGonigle KF, Barsky SH. Pseudomyxoma peritonei is a disease of MUC2- expressing goblet cells. Am J Pathol 2002; 161: 551-564.