Appendiceal Neoplasms

Abstract

Appendiceal neoplasms are rare and typically present as incidental findings upon pathologic examination following appendectomy.• Right colectomy should be considered for appendiceal adenocarcinoma, except for tumors limited to the submucosa. • Benign mucinous neoplasms are adequately treated by appendectomy provided resection margins are clear. • A perforated appendiceal tumor associated with peritoneal mucin should be treated with excision of the perforated lesion, peritoneal washings for cytology, and biopsy of any suspicious peritoneal lesions. Formal cytoreductive surgery should be delayed and performed by a specialized surgeon. • Neuroendocrine tumors smaller than 2 cm are adequately treated with appendectomy alone. • Neuroendocrine tumors larger than 2 cm, or those having high-risk features (incomplete resection, location at the base of the appendix, Ki 67 > 2%, lymphovascular or perineural invasion, mesoappendix invasion, grade 2 or greater) should be considered for right hemicolectomy.

Intraoperative predictors of appendiceal abnormalities in patients with mucinous ovarian neoplasms

“…This may range from ongoing surveillance imaging to consideration of diagnostic laparoscopy and, if indicated, potentially cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. 16 The overall incidence of NET of the appendix reported in the literature is 3-9/1000 (0.3%-0.9%) and they are most commonly detected in patients in their 40s. In our study, the incidence was nearly double at 1.8%.…”

“…In addition, if there is high‐risk pathology such as the presence of cellular mucin outside the appendix, then additional management would be required. This may range from ongoing surveillance imaging to consideration of diagnostic laparoscopy and, if indicated, potentially cytoreductive surgery and hyperthermic intraperitoneal chemotherapy 16 …”