Serrated Adenoma of the Inverted Vermiform Appendix Showing a Gigantic Pedunculated Polyp-Like Appearance

Intramucosal Carcinoma of the Appendix Arising from Traditional Serrated Adenoma

“…Among the main polyps that develop in the vermiform appendix, adenomas (villous, tubular-villous, and tubular) and serrated polyps (SPs) are the most common and deserve special attention due to the possibility of malignant degeneration to cancer. The preoperative diagnosis of polyps of the appendix is difficult, and a review of such cases showed that more than 93% were diagnosed after an appendectomy or at autopsy [ 12 , 19 , 21 , 22 ]. Occasionally, these lesions are found incidentally while performing an ultrasound or computed tomography study to evaluate other conditions of the abdominal cavity [ 19 ].…”

“…The term SPs is used for polyps with a serrated aspect of the epithelial surface and crypt epithelium, which most likely occurs due to an increase in the cellular proliferation in the crypt zone, as well as due to inhibition of programmed cellular death of the specialty cells located on the top of the colonic glands [ 4 ]. A review of the literature revealed that only one case was published before 2004 [ 6 ] and fewer than 50 cases have been described to date [ 3 – 12 ].…”

“…Other possible manifestations included a palpable abdominal mass, ascites, carcinomatosis and peritonitis resulting from a perforated appendix, and a variety of nonspecific symptoms [ 16 ]. Rarely, SSA of the appendix was shown to lead to an intussusception of the appendix [ 10 , 12 ]. Usually, the above presentations were incidental findings during intra-abdominal surgery, during abdominal CT scans for other medical conditions, or during a colonoscopy performed to screen for colorectal cancer, as in the patient in this report.…”

“…The incidence of SSA in the appendix is unknown, but a review of the literature revealed that fewer than 50 cases have been described [ 3 – 12 ]. This report describes a case of traditional serrated adenoma of the appendix with an intraepithelial carcinoma removed by laparoscopic resection of the appendix and part of cecal wall, where the diagnosis was confirmed by a histopathological study.…”