Clinicopathological Profile and Management of Appendiceal Neoplasm: An Observational Study

Appendiceal neoplasms are rare and frequently diagnosed incidentally during histopathological examination of appendectomy specimens. Recent data suggest that their incidence is increasing worldwide. This study aimed to evaluate the appendiceal neoplasm in appendectomy specimens, determine their clinicopathological presentation, histological subtypes, diagnostic modalities used, and the outcomes at the Tribhuvan University Teaching Hospital, Kathmandu, Nepal.

A retrospective evaluation of patients diagnosed with appendiceal neoplasm was conducted from January 2013 to December 2023 at Tribhuvan University Teaching Hospital in Kathmandu, Nepal. Ethical approval was obtained from the Institutional Review Board (Ethical Approval Reference No: 32081/082). Various parameters, including demographic profiles, disease pathology and outcomes were studied.

A total of 57 cases of appendiceal neoplasm were identified during the study period. The mean age at diagnosis was 47.1±18.5 years. Among them, 29 (50.87%) were male and 28 (49.12%) were female. Of the total cases, 52 (91.22%) cases were primary appendiceal neoplasms, 3 (5.26%) were secondary, and 2 (3.50%) cases remained unclassified. The primary mucinous appendiceal neoplasm was seen in 43 (75.44%), followed by neuroendocrine tumor in 5 (8.77%) cases. Appendectomy was performed in 29 (50.88%) and right hemicolectomy in 15 (26.32%) cases. The major perioperative complications were observed in 2 (3.50%) cases, with 1 (1.75%) case of mortality.

The number of diagnosed appendiceal neoplasms increased over the year with mucinous tumors being predominant followed by neuroendocrine tumor. Appendectomy was adequate in most cases, with limited need for further surgery, and outcomes remain excellent despite few of them developed major postoperative complications.