Low-Grade Appendiceal Mucinous Neoplasms Confined to the Appendix: Clinical Manifestations and CT Findings

Yu, Xiangrong; Murai, Jun; Tang, Wei; Meng, Xiangying; Tian, Ye; Du, Zhenggui

doi:10.1136/jim-2018-000975

Cited by 18 publications

(22 citation statements)

References 31 publications

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“…Visualization of the appendix revealing the diameter of the appendix exceeding 15 mm are considered to be a specific appendiceal mucocele index [20,21]. In CT, a well-capsulated cystic formation with calcificates in the wall is visualized [22,23]. Another indicator is the presence of appendiceal lumen exceeding 13 mm [24].…”

Section: Discussionmentioning

confidence: 99%

Analysis of Clinical Characteristics of Low-Grade Appendiceal Mucinous Neoplasm (LAMN): A Retrospective Cohort Study of 51 LAMN Patients

Xiao

Liu

2020

Journal of Investigative Surgery

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Introduction: Low-grade appendiceal mucinous neoplasm (LAMN) is a rare disorder. There is no consensus on the prognosis and management of LAMN. Materials and methods: We reviewed 51 consecutive patients with LAMN from 2013 to 2018. We divided our patients into two groups. The first is patients with an intact appendix. The second group comprises patients with the potential to develop a malignant condition. Comparisons of serum tumor markers between two groups were performed. Survival curves were estimated. Univariate and multivariate Cox proportional hazards were computed for 46 patients with median follow-up of 2.7 years. Results: Comparison of patients in two groups revealed significant differences in the mean level and abnormal ratio of CA125 (p < 0.001, p < 0.001), CA19-9 (p ¼ 0.04, p ¼ 0.04), and CEA (p ¼ 0.001, p ¼ 0.02). Eight patients had relapsed by the last follow-up in the second group. Patients with normal CEA had significantly longer disease-free survival (DFS) time than those with abnormal CEA (p ¼ 0.04). CA19-9 exhibited a significant association with DFS (HR ¼ 5.72, p ¼ 0.02) in the Univariate Cox proportional hazards. Discussion: The prognosis of LAMN is related to serum tumor markers, the surgical procedure and the pathology.

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Section: Discussionmentioning

confidence: 99%

Analysis of Clinical Characteristics of Low-Grade Appendiceal Mucinous Neoplasm (LAMN): A Retrospective Cohort Study of 51 LAMN Patients

Xiao

Liu

2020

Journal of Investigative Surgery

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“…It is necessary to perform an abdominal CT examination for those with an unknown diagnosis. The CT examination assists in judging the correlation between the tumors and surrounding tissues, contributing to improvements in the preoperative diagnosis rate ( 29 ). In this study, all patients underwent abdominal color Doppler ultrasound or CT before surgery.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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ObjectiveAppendiceal mucinous neoplasm (AMN) is a rare obstructive dilatation of the appendix caused by an intraluminal accumulation of mucoid material, showing an insidious onset and few specific clinical manifestations. The purpose of the study is to analyze clinicopathological characteristics of primary AMN and recurrence after radical resection.MethodsA total of 50 patients were included in the retrospective cohort study of AMN. Patient data, such as demographics, tumor characteristics, surgical management, preoperative serum carcinoembryonic antigen (CEA), and carcinoembryonic antigen 19-9 (CA19-9) levels, were collected. All patients were followed-up with interval CT scans until the end of December 2021, with overall survival (OS) and progression-free survival (PFS) being calculated.ResultsAll patients were confirmed as AMN by pathological diagnosis after surgery, including 28 cases (56.00%) of low-grade AMN (LAMN) and 22 cases (44.00%) of non-LAMN. Among 50 patients with AMN, there were 12 cases (24.00%) complicated with pseudomyxoma peritonei (PMP). Higher proportions of patients with pTis, pT3, pT4a, ruptured at presentation, and PMP were found in patients with non-LAMN patients than LAMN (p < 0.05). There was a remarkable difference about preoperative serum CA19-9 levels between patients with LAMN and non-LAMN (p = 0.044). Patients complicated with PMP had a higher proportion of patients with ruptured at presentation than those who were not (p < 0.001). The patients with PMP had increased tumor size compared with those without PMP (p = 0.031). Remarkable differences were observed in terms of preoperative serum CA19-9 (p = 0.009) levels between patients with PMP and without PMP. We performed a multivariate analysis of the presence or absence of PMP and found that ruptured at presentation was found to be a risk factor for PMP in patients with AMN (p = 0.003). The PFS in the patients with PMP and those without was 33.33% (4/12) and 2.63% (1/38), showing a significant difference (P = 0.002).ConclusionThe study demonstrates that ruptured at presentation and PMP may influence the prognosis and survival of patients with AMN.

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“…A large case series indicated that the median age at LAMN diagnosis is 61 years, which is close to the age of our patient[ 7 ]. In terms of sex, the literature reports a higher prevalence in females (the female/male ratio varies from 7:1[ 8 ] to 1.4:1[ 9 ]). Similarly, ovarian carcinoma occurs at the median age of 63 years[ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Low-grade mucinous appendiceal neoplasm mimicking an ovarian lesion: A case report and review of literature

Borges¹,

Reis‐de‐Carvalho²,

Chorão³

et al. 2021

WJCC

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BACKGROUND Appendiceal tumors are rare lesions that may not be easily differentiated from primary ovarian lesions preoperatively, despite the use of advanced diagnostic methods by experienced clinicians. CASE SUMMARY A 59-year-old G2P2 woman, with chronic pelvic pain, underwent a pelvic ultrasound that revealed an adnexal mass measuring 58 mm × 34 mm × 36 mm, with irregular borders, heterogeneous echogenicity, no color Doppler vascularization and without acoustic shadowing. Normal ovarian tissue was visualized in contact with the lesion, and it was impossible to separate the lesion from the ovary by applying pressure with the ultrasound probe. Ascites, peritoneal metastases or other alterations were not observed. With the international ovarian tumor analysis ADNEX model, the lesion was classified as a malignant tumor (the risk of malignancy was 27.1%, corresponding to Ovarian-Adnexal Reporting Data System category 4). Magnetic resonance imaging confirmed the presence of a right adnexal mass, apparently an ovarian tumor measuring 65 mm × 35 mm, without signs of invasive or metastatic disease. During explorative laparotomy, normal morphology of the internal reproductive organs was noted. A solid mobile lesion involved the entire appendix. Appendectomy was performed. Inspection of the abdominal cavity revealed no signs of malignant dissemination. Histopathologically, the appendiceal lesion corresponded to a completely resected low-grade mucinous appendiceal neoplasm (LAMN). CONCLUSION The appropriate treatment and team of specialists who should provide health care to patients with seemingly adnexal lesions depend on the nature (benign vs malignant) and origin (gynecological vs nongynecological) of the lesion. Radiologists, gynecologists and other pelvic surgeons should be familiar with the imaging signs of LAMN whose clinical presentation is silent or nonspecific. The assistance of a consultant specializing in intestinal tumors is important support that gynecological surgeons can receive during the operation to offer the patient with intestinal pathology an optimal intervention.

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Low-Grade Appendiceal Mucinous Neoplasms Confined to the Appendix: Clinical Manifestations and CT Findings

Cited by 18 publications

References 31 publications

Analysis of Clinical Characteristics of Low-Grade Appendiceal Mucinous Neoplasm (LAMN): A Retrospective Cohort Study of 51 LAMN Patients

Analysis of Clinical Characteristics of Low-Grade Appendiceal Mucinous Neoplasm (LAMN): A Retrospective Cohort Study of 51 LAMN Patients

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

Low-grade mucinous appendiceal neoplasm mimicking an ovarian lesion: A case report and review of literature

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