Incidental appendiceal neoplasms: Single-centre results.

Area of Science:

• Gastroenterology
• Surgical Pathology
• Oncology

Background:

• Histopathological examination of appendectomy specimens is crucial for identifying malignancies.
• Malignancy findings can dictate whether appendectomy alone is sufficient or if additional treatment is necessary.

Purpose of the Study:

• To examine cases diagnosed with malignancy on appendectomy specimens.
• To analyze the types and outcomes of appendix malignancies found during appendectomies.

Main Methods:

• Retrospective evaluation of patients who underwent appendectomy between January 2013 and December 2018 with a pre-diagnosis of acute appendicitis.
• Inclusion of cases with confirmed malignancy on the appendectomy specimen.
• Recording of patient demographics, tumor characteristics (type, diameter, grade, localization), surgical margins, Ki-67 index, lymphovascular invasion, perineural invasion, and follow-up duration.

Main Results:

• Out of 2336 appendectomy specimens, 16 (0.7%) had neuroendocrine tumors (NET), 11 (0.5%) had low-grade mucinous neoplasm (LAMN), and 5 (0.2%) had primary appendix carcinomas.
• Appendix tumors commonly present with symptoms of acute appendicitis.
• Appendectomy is adequate for most NET and LAMN cases, while adenocarcinoma may require right hemicolectomy (RHC).

Conclusions:

• Neuroendocrine tumors and low-grade mucinous neoplasms of the appendix generally have a benign prognosis.
• While appendectomy is sufficient for many appendix tumors, careful postoperative screening and follow-up are essential.
• Further treatment protocols, such as right hemicolectomy, may be necessary for certain appendix carcinomas.