Endoscopically unobservable appendiceal adenoma treated using laparoscopically assisted surgery.

Area of Science:

• Gastroenterology
• Surgical Oncology

Background:

• Primary benign adenomas of the appendix are rare, occurring in approximately 0.02-0.08% of cases.
• Appendiceal adenomas are sporadically reported in appendectomy and autopsy findings.

Purpose of the Study:

• To report a unique case of a disappearing appendiceal adenoma.
• To discuss the diagnostic and therapeutic challenges of appendiceal adenomas.

Main Methods:

• A 58-year-old woman presented with a polyp in the appendiceal orifice identified during lower gastrointestinal endoscopy.
• The polyp was not found during a subsequent endoscopy, leading to an appendectomy for diagnosis and treatment.
• Pathological examination revealed a low-grade atypical tubular adenoma without malignancy.

Main Results:

• The appendiceal polyp was initially observed but subsequently disappeared before surgical intervention.
• Appendectomy confirmed a benign tubular adenoma, with no signs of malignancy.
• Laparoscopic appendectomy was performed, proving to be a safe and curative option.

Conclusions:

• Appendiceal adenomas can exhibit spontaneous resolution, influenced by examination and treatment timing.
• Surgical resection, including laparoscopic approaches, remains the standard treatment for appendiceal adenomas due to perforation risks.
• Patients undergoing appendectomy for adenoma should be counseled on potential cancer risks and the need for further management.