Appendiceal neuroma: an uncommon entity

Jagtap, Sunil Vitthalrao; Boral, Saswati; Jagtap, Shubham S.; Ajagekar, Pratik D.

doi:10.18203/2349-2902.isj20193011

Cited by 5 publications

(4 citation statements)

References 5 publications

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“…It is usually found in older individuals but is occasionally seen in young patients. [9] Clinically, it is usually an incidental and asymptomatic nding, but it can mimic appendicitis. [7,10] Histopathologically, there was a proliferation of S100-positive nerve tissue.…”

Section: Discussionmentioning

confidence: 99%

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Amyand’s Hernia Containing Appendiceal Neuroma, Presented as Incarcerated Inguinal Hernia: A Rare Case Report from Ethiopia

Hailu,

Asmare

2023

Preprint

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Introduction and importance: We report an extremely rare case of appendiceal neuroma, presented as an incarcerated Amyand’s hernia. Case presentation: A 55-year-old male presented in the emergency department due to a persistent right inguinal painful swelling. Clinical examination revealed a 5cm x 3cm firm and irreducible right groin mass. Under the diagnosis of an incarcerated right inguinal hernia, an emergency operation was performed. Intraoperatively, a 5cm x 3cm firm mass originating from the distal part of the appendix was found in the hernia sac. The operation was completed with an appendectomy and a modified Bassini hernia repair. Histological examination revealed appendiceal neuroma, and no further surgical intervention was needed. Discussion: Appendiceal neuroma is a benign stromal tumor whose diagnosis is typically made by histopathologic study. Though not clear, pathogenesis is believed to stem from the proliferation of neuroendocrine cells due to frequent inflammatory attacks. It is usually confused with the presentation of appendicitis, and the diagnosis is confirmed after the appendectomy. Amyand’s hernia, on the other hand, is an inguinal hernia whose content is either normal or diseased appendix vermiformis. In the literature, very limited case reports of Amyand’s hernia containing a carcinoid tumor, goblet cell carcinoid tumor, mucinous cystadenoma, adenocarcinoma, and villous adenoma are listed. However, we found no single reported case of Amyand’s hernia containing appendiceal neuromas in our search of English literature using Google Scholar and PubMed search engines. Conclusion: Amyand’s hernia containing appendiceal neuroma is an extremely rare entity. We found no case report in the accessible literature. Histopathological evaluation is important to differentiate appendiceal neuroma from malignant tumors of the appendix. An appendectomy alone with hernia repair is adequate treatment.

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Section: Discussionmentioning

confidence: 99%

“…The process may be con ned to the mucosa or may replace the entire lumen [6]. Immunohistochemical staining con rms the diagnosis of appendiceal neuroma, where the neoplasm cells are stained with S-100 protein [5,6,9]. The treatment of choice is surgical excision of the appendix.…”

Section: Discussionmentioning

confidence: 99%

Amyand’s Hernia Containing Appendiceal Neuroma, Presented as Incarcerated Inguinal Hernia: A Rare Case Report from Ethiopia

Hailu,

Asmare

2023

Preprint

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“…But in 2018 Dincel et al 4 reported that ~1% of the resected appendix specimens showed fibrous obliteration and neuroma. Neuroma of the appendix is a rare disease of neural origin that usually mimics the symptoms of the acute appendicitis 31 , patient's physical examination and laboratory findings can help in the differential diagnosis, but most of these cases only become evident when the histopathology examination is available 32 .…”

Section: Discussionmentioning

confidence: 99%

The Utility of Routine Histopathological Examination of the Appendectomy Specimens

Hasan¹,

Nafie²,

Abbadi³

et al. 2020

Ann of Pathol and Lab Med

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Background: Appendectomy is the most commonly performed surgical procedure worldwide to manage appendicitis. The practice of sending all appendices specimens for routine histopathology examination depends on the concerned clinician. This study was performed to reveal the importance of routine histopathology examination of the appendectomy specimens with recording of the occurrence and distribution of unusual pathologic findings Methods: This was a retrospective record based comparative study performed in a single Hospital in Saudi Arabia, where the medical files of 766 patients were recruited. The appendectomy specimens were obtained either from our hospital or referred from any other hospital for histopathology examination. All the unusual diagnoses were reviewed by the histopathology author and blindly re-evaluated by other pathology consultant. Statistic analysis was performed manually. Result: 700 cases were within the usual histopathology scope. Unusual histopathological findings were observed in 66 cases (8.6%): four cases of mucinous neoplasms, 20 cases of fibrous obliteration or appendiceal neuroma, 18 cases showed parasitic infestation, and 24 cases were periappendicitis without appendicular acute inflammation. Conclusion: Routine histopathology examination of the appendix not only confirms the clinical diagnosis of acute appendicitis, but also leads to the incidental diagnosis of much unusual pathologies which could have been missed by the surgeon, and these pathologies include parasitic infestation, peri-appendicitis, neuromas and appendiceal mucinous neoplasms.

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“…The process begins at the appendiceal tip and will proceed proximally over time and may affect the entire appendix. No treatment is required, however, as this is usually found incidentally, the prognosis is related to the underlying condition that led to resection [18][19][20][21][22][23].…”

Section: Fibrous Obliterationmentioning

confidence: 99%

Appendectomy in endometriosis: an update on surgical indications and management of uncommon diseases

Galaviz

Nguyen

Sticco

et al. 2023

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewAbnormal appendiceal disease is commonly encountered following an appendectomy when performed in patients with endometriosis. Appendiceal endometriosis is the most notable finding and can affect up to 39% of patients with endometriosis. Despite this knowledge, guidelines for performing an appendectomy have not been formally established. In this article, we review the surgical indications for an appendectomy at the time of endometriosis surgery and discuss the management of other diseases that may be encountered following the histopathologic evaluation of an excised appendix.Recent findingsRemoval of the appendix in patients with endometriosis contributes to optimal surgical management. Relying on abnormal appendiceal appearance for removal may leave endometriosis-affected appendices. For this reason, utilizing risk factors to guide surgical management is essential. Common appendiceal diseases are sufficiently managed with appendectomy. Uncommon diseases may require further surveillance.SummaryEmerging data in our field support the performance of an appendectomy at the time of endometriosis surgery. Guidelines for performing a concurrent appendectomy should be formalized to encourage preoperative counselling and management for patients with risk factors for appendiceal endometriosis. Abnormal diseases is frequently encountered after appendectomy in the setting of endometriosis surgery and further management is based on the histopathology of the specimen.

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Appendiceal neuroma: an uncommon entity

Cited by 5 publications

References 5 publications

Amyand’s Hernia Containing Appendiceal Neuroma, Presented as Incarcerated Inguinal Hernia: A Rare Case Report from Ethiopia

Amyand’s Hernia Containing Appendiceal Neuroma, Presented as Incarcerated Inguinal Hernia: A Rare Case Report from Ethiopia

The Utility of Routine Histopathological Examination of the Appendectomy Specimens

Appendectomy in endometriosis: an update on surgical indications and management of uncommon diseases

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