Incidence of appendiceal neoplasms in appendectomy patients

Abstract

Background Non-operative management has been suggested as a therapy for uncomplicated appendicitis. Notwithstanding, the risk of missing an appendiceal tumor must be considered, being the surgical piece crucial to rule out neoplasms. Therefore, we aim to determine the incidence of appendiceal neoplasms in patients with acute appendicitis, tumor types and the importance of the anatomopathological study of the surgical piece. Study design Retrospective study in which we described patients who underwent emergent appendectomy with histopathological findings of appendiceal neoplasms from January 2012 to September 2018. Descriptive analysis included demographic variables, diagnostic methods, and surgical techniques. Results 2993 patients diagnosed with acute appendicitis who underwent an emergency appendectomy. 64 neoplasms of the appendix were found with an incidence of 2,14%. 67.2% were women, the mean age was 46,4 years (± 19.5). The most frequent appendiceal neoplasms were neuroendocrine tumors (42,2%), followed by appendiceal mucinous neoplasms (35,9%), sessile serrated adenomas (18,8%), and adenocarcinomas (3,1%). In 89,1% of the cases, acute appendicitis was determined by imaging, and 14% of cases were suspected intraoperatively. Appendectomy was performed in 78,1% without additional procedures. Conclusions Appendiceal tumors are rare and must be ruled out in patients with suspected acute appendicitis. The incidence of incidental neoplasms is higher in this study than in the previously reported series. This information must be included in decision-making when considering treatment options for acute appendicitis.

Survival among 148 patients with an incidentally detected appendiceal tumour at surgery for acute appendicitis: A population-based cohort follow-up study

“…Acute appendicitis (AA) is one of the most common conditions requiring acute surgery. Subsequent histopathology reveals that 0.5-2% of all appendices have some form of neoplasia (1)(2)(3)(4). The gure is higher with complicated AA (5).…”

Metastatic Breast Cancer Presenting as Acute Appendicitis: A Rare Case Study and Review of Current Knowledge

“…Acute appendicitis is frequently encountered in emergency departments, primarily resulting from luminal obstruction at the appendicular base due to factors like fecaliths or lymphoid hyperplasia [1]. Malignant tumors account for less than 1% of these cases [2]. In exceptionally rare instances, acute appendicitis can arise due to metastases from extraabdominal neoplasms, including breast cancer [3].…”