Importance of Histologic Subtype in the Staging of Appendiceal Tumors

Turaga, Kiran K.; Pappas, Sam G.; Gamblin, T. Clark

doi:10.1245/s10434-012-2238-1

Cited by 193 publications

(191 citation statements)

References 11 publications

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“…In terms of patient characteristics, a slightly higher incidence among females (Shaib et al 2015) has been shown in most but not all epidemiological studies (Sandor & Modlin 1998, Hemminki & Li 2001, Prommegger et al 2002, Van Gompel et al 2007, Landry et al 2008, Turaga et al 2012) -a fact that has been attributed to the increased rate of surgical interventions performed in women (Moertel et al 1968, Shapiro et al 2010, Carpenter et al 2012. A possible hormonal influence has not been proven (Graham et al 2009).…”

Section: Epidemiologymentioning

confidence: 99%

“…An epidemiological study from Sweden covering the years showed that, of 5184 NENs, the appendix was the main site of involvement in women, whereas the SI was the main site in men; aNENs showed an unusually early onset with a maximum incidence at age 15-19 years in women and 20-29 years in men (Hemminki & Li 2001). Indeed, aNENs are diagnosed at a much younger age of 32-42.2 years (Hemminki & Li 2001, McGory et al 2005, Graham et al 2009, Benedix et al 2010, Turaga et al 2012, Hsu et al 2013 compared to other GI-NENs and all other appendiceal neoplasms, which are diagnosed at an average age of 62.9 and 61.9 years, respectively (Sandor & Modlin 1998). In a large series from The Netherlands, the appendix was the most frequently diagnosed primary site of NENs in patients !35 years (Quaedvlieg et al 2001).…”

Section: Epidemiologymentioning

confidence: 99%

See 1 more Smart Citation

Appendiceal neuroendocrine neoplasms: diagnosis and management

Alexandraki¹,

Kaltsas²,

Grozinsky‐Glasberg³

et al. 2015

Endocrine-Related Cancer

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Gastrointestinal neuroendocrine neoplasms (GI-NENs) are increasingly being recognised, while appendiceal NENs (aNENs) currently constitute the third most common GI-NEN. Appendiceal NENs are generally considered to follow an indolent course with the majority being localised at diagnosis. Thus, the initial surgical approach is not that of a planned oncological resection. Due to the localised nature of the disease in the majority of cases, subsequent biochemical and radiological assessment are not routinely recommended. Histopathological criteria (size, mesoappendiceal invasion, Ki-67 proliferation index, neuroand angio-invasion) are mainly used to identify those patients who are also candidates for a right hemicolectomy. Goblet cell carcinoids are a distinct entity and should be treated as adenocarcinomas. Despite the absence of any substantial prospective data regarding optimal management and follow-up, recent consensus statements and guidelines have been published. The purpose of this review is to overview the published studies on the diagnosis and management of appendiceal NENs and to suggest a possible management protocol.

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Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

Appendiceal neuroendocrine neoplasms: diagnosis and management

Alexandraki¹,

Kaltsas²,

Grozinsky‐Glasberg³

et al. 2015

Endocrine-Related Cancer

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“…Tumores menores de 2 cm, sin compromiso a distancia, tendrán tasas de sobrevida a los 5 años cercanas al 100%; sin embargo, los tumores entre 1 y 2 cm, con metástasis ganglionar o mayores de 2 cm, la sobrevida descenderá al 78%, en el mismo rango de tiempo. Cuando el compromiso metastásico es orgánico, generalmente hepático en este tipo de tumores, independientemente del tamaño, caerá al 32% (13,14).…”

Section: Discussionunclassified

Tumor carcinoide del apéndice cecal: cuando un hallazgo incidental modifica drásticamente el pronóstico y tratamiento del paciente

Rivera

Buitrago-Toro

Gonzales³

2017

Rev. Colomb. Gastroenterol.

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Introducción: la apendicectomía es un procedimiento ampliamente utilizado en todo el mundo, bien sea como consecuencia de signos y síntomas sugestivos de apendicitis aguda o como resección profiláctica.El estudio de la pieza quirúrgica es frecuente, a pesar de la baja incidencia de hallazgos inusuales en esta. Los tumores del apéndice cecal constituyen el 1% de todas las neoplasias intestinales, siendo los de tipo carcinoide los más frecuentes en el apéndice cecal.Objetivo: exponer el caso de un tumor carcinoide del apéndice cecal como hallazgo incidental por apendicectomía profiláctica laparoscópica en un procedimiento ginecológico.Caso clínico: paciente de 58 años de edad, con antecedente patológico de miomatosis uterina e histerectomía en 2010, que consulta por cuadro clínico de dos años de evolución de dolor pélvico crónico. Es llevada a liberación de adherencias intraperitoneales que afectan el apéndice cecal, por lo que se realiza apendicetomía, que en el análisis histopatológico identifica tumor carcinoide típico.Discusión:los tumores carcinoides son neoplasias neuroendocrinas que pueden ser identificadas en múltiples localizaciones; sin embargo, el tracto gastrointestinal es el más frecuente. El compromiso de apéndice cecal no es común y suele ser detectado incidentalmente durante apendicectomías profilácticas. La identificación de este tipo de neoplasias en un estudio de rutina modificará drásticamente el manejo del paciente, ya que dependiendo de su tamaño, extensión y localización, requerirá un manejo y seguimiento específico.

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“…Extraperitoneal spread is associated with relatively good prognosis by preventing the development of peritoneal carcinomatosis [6,7]. Unusual presentation includes haematuria due to bladder infiltration, direct invasion of ascending colon detected on colonoscopy, intussusception, hydronephrosis due to ureteric infiltration, retroperitoneal abscess, vaginal bleeding, lower gastrointestinal bleed, epididimitis in case of metastases to the spermatic cord or testicles, ovarian mass due to Krukenberg tumor and cutaneous infiltration [5,[8][9][10][11][12][13][14]. Management of appendiceal neoplasms should follow oncosurgical principles same as colorectal adenocarcinomas.…”

Section: Discussionmentioning

confidence: 99%

A Rare Cause of Painless Haematuria- Adenocarcinoma of Appendix

Sahu¹,

Agarwal²,

Agrawal³

et al. 2016

Surgery

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Journal of Surgery IntroductionNeoplasms of the appendix are rare, accounting for less than 0.5% of all gastrointestinal malignancies and found incidentally in approximately 1% of appendectomy specimen. Carcinoids are the most common appendicular tumors, accounting for approximately 66%, with cystadenocarcinoma accounting for 20% and adenocarcinoma accounting for 10% [1]. We present a case of adenocarcinoma of appendix presenting only with a recurrent painless haematuria. Case ReportA 79 year male presented to our surgical clinic with history of recurrent attacks of painless haematuria since last 5 months. There was no history of any fever, pain abdomen or any other urinary complaints. Patient had history of similar attacks 5 months back for which he was investigated by routine haemogram and urine analysis. During that time his total leukocyte count was around 9000 cu/mm with urine analysis showed 15-20 red blood cells without any pus cells. He was taken up for cystoscopy which revealed a congested area in the bladder mucosa suggestive of cystitis. Then oral and intravenous contrast enhanced CT scan abdomen was planned which was reported to be acute appendicitis complicated by cystitis. Conservative management in the form Oshner Sherren's regiment with a plan of subsequent interval appendectomy was planned. Patient then had an uneventful recovery then with that conservative management. General physical examination at this time of presentation was unremarkable. Examination of abdomen showed mild tenderness in the suprapubic and right iliac fossa region without any palpable mass. Complete haemogram showed haemoglobin 13.23 g/dl, total leukocyte count-7000 cu/mm with differential leukocyte count showing neutrophil-72%, lymphocyte-18%, monocyte-10%. Routine urine test showed 5-7 red blood cells/high power fields. Liver function test and renal function test was within normal limits. Oral and intravenous contrast enhanced CT scan of abdomen was planned which showed a heterogeneously enhancing oblong mass lesion measuring approximately 6 × 2.5 cm replacing the appendix with the tip of the lesion having an ill-defined interface with the dome of the urinary bladder suggestive of infiltration. No evidence of intrinsic mass lesion was seen within the urinary bladder. No abdominal lymphadenopathy or free intraperitoneal free fluid was detected. Interface between the mass lesion with bowel loops, right iliac vessels and right ureter was well maintained (Figure 1). Patient was planned cystoscopy followed by exploratory laparotomy. On cystoscopy an external bulge in the anterior urinary bladder wall with an area of mucosal erosion showing mild bleeding was seen. No intrinsic mass lesion was detected in the urinary bladder (Figure 2). Exploratory laparotomy was done. Appendicular growth was seen invading the dome of the urinary bladder ( Figures 3 and 4). Right hemicolectomy with en bloc resection of invasion in urinary bladder was done. Primary Ileo transverse anastomosis with repair of the urinary bladder wall was done under...

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Importance of Histologic Subtype in the Staging of Appendiceal Tumors

Abstract: Histologic subtype is an important predictor of disease-specific survival and overall survival in patients with appendiceal neoplasms. Addition of the histologic subtype to the TNM staging is simple and may improve prognostication.

Cited by 193 publications

References 11 publications

Appendiceal neuroendocrine neoplasms: diagnosis and management

Appendiceal neuroendocrine neoplasms: diagnosis and management

Tumor carcinoide del apéndice cecal: cuando un hallazgo incidental modifica drásticamente el pronóstico y tratamiento del paciente

A Rare Cause of Painless Haematuria- Adenocarcinoma of Appendix

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