Clinicopathological Characteristics of Primary Appendiceal Mucinous Neoplasm and Recurrence After Radical Resection

Wang, Zaibiao; Yin, Manman; Shao, Jiayun; Yin, Zhipeng; Peng, J L; Lu, Zhengmao

doi:10.3389/fsurg.2022.902543

Cited by 2 publications

(3 citation statements)

References 34 publications

(29 reference statements)

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“…The utility of positron emission tomography and computed tomography (PET-CT) scans is still under study and has limited value in mucinous neoplasms, although it may predict the grade of these lesions in some cases [6]. Colonoscopy is recommended in patients with appendicular mucinous neoplasms to rule out synchronous colorectal tumors, although their incidence is lower compared to primary colorectal neoplasms [6][7][8]. The role of diagnostic laparoscopy is primarily to identify the resectability of lesions, perform biopsies, and avoid unnecessary laparotomies in late stages that often require more aggressive management with the need for chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that in localized tumors to the appendix, appendectomy is often sufficient as an oncological resection when compared to wider resections, with no impact on five-year overall survival or disease-free survival. The only indication for a more extensive resection is the presence of positive margins in the specimen; however, its management remains controversial [8]. It is important to note that, due to the low incidence of lymph node metastasis, extensive resection is sometimes excessive.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the low lymph node invasion observed in these neoplasms (2%), appendectomy may be considered if the entire tumor is excised. Extensive resections or right hemicolectomy are reserved for tumors larger than 2 cm, involving the periappendiceal area, high-grade neoplasms, or those with invasion beyond the muscularis mucosae to reduce the risk of local recurrence [8][9][10]. In mucinous neoplasms with acellular mucin and peritoneal invasion, cytoreduction or right hemicolectomy is usually sufficient with close followup.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Lower Gastrointestinal Bleeding Secondary to Appendiceal Mucinous Neoplasm: A Report of Two Cases and a Review of the Literature

Soto Llanes,

Dosal Limón,

Iberri Jaime

et al. 2024

Cureus

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Appendicular mucinous neoplasms, constituting less than 1% of gastrointestinal tract neoplasms, are heterogeneous entities. They may be asymptomatic, discovered incidentally, or present as large tumors due to mucin accumulation. The lack of standardized treatment complicates management. Imaging studies, particularly CT scans, are crucial for diagnosis and follow-up. This case report presents two clinical cases of women in their sixth and seventh decades of life with a history of lower gastrointestinal bleeding, mild anemia in laboratory studies, and incomplete colonoscopies. The diagnosis, confirmed through CT scans, led to the decision for surgical intervention in both cases, involving laparoscopic right hemicolectomy with ileotransverse anastomosis. Subsequently, histopathological reports confirmed the diagnosis of high-grade appendicular mucinous neoplasms, and a follow-up plan was established with imaging studies every six months with no recurrence at two years.Over 50% of appendicular tumors are mucinous neoplasms originating from low-grade mucinous neoplasms. Given the low lymph node invasion (2%), appendectomy may suffice if the entire tumor is excised. Extensive resections or right hemicolectomy are reserved for larger tumors or high-grade neoplasms to minimize local recurrence risk. Mucinous neoplasms with acellular mucin and peritoneal invasion may require cytoreduction or right hemicolectomy, while those with mucinous epithelium may need hyperthermic intraperitoneal chemotherapy (HIPEC) due to the risk of local recurrence, worsened by the presence of extra appendiceal epithelial cells. Disease-free and overall survival depend on treatment and initial lesion characterization. A five-year survival rate of 86% is reported for low-grade mucinous neoplasms. Follow-up approaches lack an ideal standard, generally involving physical examinations and imaging studies every six months to one year during the first six years.

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