Acute Appendicitis Caused by Metastasis from Other Organs: A Systematic Review

Area of Science:

• Oncology
• Gastroenterology
• Surgical Pathology

Background:

• Acute appendicitis is a common surgical emergency, typically caused by mucosal inflammation.
• Appendicitis originating from metastatic disease is exceptionally rare, with limited case reports.
• This study systematically reviews published literature on metastatic appendicitis.

Purpose of the Study:

• To analyze the characteristics of patients with acute appendicitis secondary to metastasis.
• To understand the primary tumor origins and clinical presentation of metastatic appendicitis.
• To evaluate treatment outcomes and mortality in these rare cases.

Main Methods:

• A systematic review was conducted following the PRISMA protocol.
• Searches were performed in PubMed/MEDLINE, Embase, and Google Scholar up to December 2022.
• Data from published case reports and series were analyzed.

Main Results:

• 34 patients were included; 22 were male, with a mean age of 58.94 years.
• Primary tumor sites included lungs (32.35%), breast (20.59%), and stomach (17.65%).
• Appendicitis was the initial cancer diagnosis in 29.41% of cases; 61.77% had other metastatic sites. Postoperative mortality was 2.93%.

Conclusions:

• Metastatic appendicitis is an uncommon condition, occasionally presenting as the first sign of malignancy.
• The majority of patients exhibit other secondary tumor sites.
• Appendiceal surgery is the standard treatment for the appendicitis itself.