Retrospective case-control study to predict a potential underlying appendiceal tumor in an acute appendicitis context...

Area of Science:

• Radiology
• Oncology
• Gastroenterology

Background:

• Appendiceal neoplasms are rare but can mimic acute appendicitis.
• Accurate differentiation is crucial for appropriate management.
• CT scans are commonly used to evaluate appendicitis, but distinguishing tumors can be challenging.

Purpose of the Study:

• To develop and validate a CT-based scoring system to discriminate appendiceal tumors from non-tumoral appendicitis.
• To identify specific CT findings predictive of appendiceal neoplasms.

Main Methods:

• A 10-year retrospective case-control study included 208 adult patients with appendicitis.
• Patients with appendiceal tumors were matched with those with non-tumoral appendicitis.
• Two radiologists blindly assessed CT findings, performing univariate and multivariate analyses.

Main Results:

• Key predictors for appendiceal tumors included mural calcifications, appendix mass, focal asymmetric wall abnormality, and a diameter ≥ 15 mm.
• Appendicolith and fat stranding were found to be protective factors against tumors.
• The developed scoring system achieved an AUC of 0.87 with a positive likelihood ratio of 13.5.

Conclusions:

• A reliable CT-based scoring system can effectively predict underlying appendiceal neoplasms in the context of acute appendicitis.
• This scoring system aids in differentiating neoplastic from non-neoplastic conditions, guiding clinical decisions.