Low-Risk Non-mucinous Adenocarcinoma of the Appendix: When Is an Appendectomy Enough?

Turner, Kevin M.; Patel, Sameer H.

doi:10.1245/s10434-021-11229-x

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…Appendicular mucocele is also a rare disease with a reported incidence of 0.2 to 0.3%, histologically varying from benign to malignant with a high risk of developing pseudomyxoma of the peritoneum. In the presence of evidence of malignancy (metastatic lymph adenomegaly, perforation with intraperitoneal dissemination and affected base of the appendix (positive resection margins), the method of surgical treatment is right hemicolectomy with lymphatic dissection, while appendectomy is recommended in cases of benign mucocele (17)(18)(19).…”

Section: Discussionmentioning

confidence: 99%

Acute appendicitis without appendicitis

Daskalova,

Lavchev,

Rusenov

et al. 2023

SSM

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INTRODUCTION: A clinical, imaging, and laboratory constellation for acute appendicitis requires operative treatment to avoid life-threatening complications such as perforation and peritonitis. The latter, in turn, are an absolute indication for surgical intervention. Although it does not change the operative approach, in rare cases, the cause of the condition is appendicular diverticulitis-usually an incidental, pathological diagnosis with a literature frequency of 0.004-2.1%. The differential diagnosis of diverticula of the appendix in patients with acute appendicitis is important because of the higher risk of developing the above complications, but also because of primary neoplasms of the appendix. The latter are rare Tu with a frequency of 0.2-0.5% of all GIT neoplasms. Among them, carcinoids are the most common and are characterized by slow growth and a long asymptomatic course. However, they often present with the picture of acute appendicitis with/ without perforation, abscess or peritonitis. MATERIALS, METHODS AND RESULTS:The study was single-center, retrospective. Three patients with histologically verified appendicular diverticulitis with perforation and periappendicular abscess are presented, necessitating laparoscopic appendectomy (1 case), conventional appendectomy (1 case), right hemicolectomy (1 case). Adenocarcinoma of the appendix was proven in two patients with laparoscopic appendectomy.After verification of the permanent histological result and after discussion with the hospital Oncology Committee in the first case, the operation performed was determined to be sufficient in view of the oncological radicality. In the second case, reoperation with right hemicolectomy was recommended for histological evidence of T3 adenocarcinoma of the appendix. An appendicular mucocele was pathologically proven in one of the patients after laparoscopic appendectomy. CONCLUSION:The differential diagnosis of diverticulitis of the appendix in patients with acute appendicitis is important due to the higher risk of developing the above complications, but also because of primary neoplasms of the appendix. The latter are rare Tu with a frequency of 0.2-0.5% of all GIT neoplasms, which can also present with the picture of acute appendicitis with/without perforation, abscess or peritonitis.

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Section: Discussionmentioning

confidence: 99%

Acute appendicitis without appendicitis

Daskalova,

Lavchev,

Rusenov

et al. 2023

SSM

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“…In most cases, the mucinous glands are lined with columnar cells and excrete a reduced amount of mucin. This morphology brings this type of neoplasia closer to colorectal adenocarcinoma (sometimes classified as non-mucinous adenocarcinoma of the colorectal appendix type), from which it is differentiated by more aggressive growth and more frequent metastasis to lymph nodes [10,68]. At a distance, nonmucinous adenocarcinoma of the appendix NOS metastasizes to the liver and lung, and most cases are poorly or moderately differentiated [69].…”

Section: Appendiceal Adenocarcinomas Nos and Undifferentiated Carcino...mentioning

confidence: 99%

The Vermiform Appendix and Its Pathologies

Constantin,

Petrescu,

Mătanie

et al. 2023

Cancers

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The vermiform appendix is a muscular cylindrical structure originating near the junction of the cecum and ileum, averaging 9 cm (5–35 cm) in size. As the most mobile viscera, it can adopt several positions, the most common being the retrocecal position. Perceived as an atavistic organ lacking physiological relevance, the vermiform appendix appears to be involved in immune function, serving in the maturation of B lymphocytes and the production of immunoglobulin A, in endocrine function, excreting amines and hormones in the 2–3 mL of mucus secreted daily, and in digestive function, by storing beneficial bacteria from where they can recolonize the colon. With a lumen of about 6 mm, the vermiform appendix has a reduced storage capacity, so any blockage of the appendix with fecoliths (fecaliths), seeds derailed from the colon, or enlarged lymph nodes prevents drainage and intraluminal accumulation of secreted mucus. Unable to relax, the appendix wall severely limits its intraluminal volume, so mucus accumulation leads to inflammation of the appendix, known generically as appendicitis. In addition, the vermiform appendix may be the site of the development of neoplastic processes, which may or may not involve mucus production, some of which can significantly affect the standard of living and ultimately lead to death. In general, mucinous tumors may have a better prognosis than non-mucinous tumors. This review takes a comprehensive path, starting by describing the anatomy and embryology of the vermiform appendix and further detailing its inflammatory pathologies, pathologies related to congenital anomalies, and appendix tumors, thus creating an up-to-date framework for better understanding, diagnosis, and treatment of these health problems.

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