[Incidental finding of appendiceal mucinous neoplasms]

Area of Science:

• Gastroenterology and Surgical Oncology
• Pathology of the Appendix

Context:

• Low-grade appendiceal mucinous neoplasms (LAMN) are rare, often incidentally discovered during appendectomies.
• Tumor perforation can lead to pseudomyxoma peritonei (PMP), a significant intra-abdominal complication.

Purpose:

• To outline the diagnostic and therapeutic challenges of LAMN.
• To provide guidance on the management of incidentally discovered LAMN and PMP.

Summary:

• Management strategies for LAMN depend on preoperative suspicion, intraoperative findings, and the presence of PMP.
• Appendectomy is adequate for LAMN without PMP. PMP requires cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) at specialized centers.
• Postoperative follow-up includes imaging and tumor markers (CEA, CA 19-9, CA 125).

Impact:

• Establishes clear treatment pathways for LAMN and PMP, optimizing patient outcomes.
• Highlights the importance of specialized centers for complex cases involving PMP.
• Emphasizes avoiding intraoperative perforation and ensuring complete inspection for mucin deposits.