Management of an unexpected appendiceal neoplasm

Area of Science:

• Gastroenterology
• Surgical Oncology
• Pathology

Background:

• Appendiceal neoplasms are uncommon and frequently misdiagnosed as acute appendicitis.
• Existing literature on appendiceal tumor classification and management is limited.
• These rare tumors pose diagnostic and therapeutic challenges.

Purpose of the Study:

• To review the literature on the presentation, pathology, and management of appendiceal tumors.
• To provide clarity on the classification and treatment strategies for these rare malignancies.
• To establish guidelines for managing unexpected appendiceal tumors.

Main Methods:

• Systematic literature review.
• Analysis of publications on appendiceal tumor presentation, pathology, and management.
• Synthesis of current evidence for diagnostic and therapeutic approaches.

Main Results:

• Appendiceal tumors represent 0.4-1% of all gastrointestinal malignancies.
• Carcinoid tumors are the most frequent type, often curable with simple appendicectomy if small and without margin involvement.
• Epithelial tumors can lead to pseudomyxoma peritonei, necessitating complete resection and specialized intraperitoneal chemotherapy.

Conclusions:

• Proposed management algorithms for unexpected appendiceal tumors are presented.
• Recommendations for follow-up care of patients with perforated appendiceal epithelial tumors are provided.
• Highlights the need for specialized centers for managing complex cases like pseudomyxoma peritonei.