Status of Appendiceal Neoplasms in Acute Appendicitis Cases

Abstract

Introduction:Appendiceal neoplasms (AN) are exceedingly rare and mostly diagnosed incidentally during appendectomy due to non-specific clinical manifestations. Our study focused on assessing the clinical and postoperative histopathological features of ANs to differentiate them from acute appendicitis (AA) diagnosis in order to prevent complications and metastasis in aggressive malignancies.Methods:In this retrospective study, we analyzed 2,906 patients who underwent a appendectomy. We compared the demographic characteristics, imaging, and preoperative laboratory findings and postoperative histopathology results between the groups with AN and AA.Results:The prevalence of AN was found to be 2.82% (n=82). We observed a significant difference in age between patients diagnosed with AN and those with AA, with patients being notably older. The rate of perforation and diverticula was also increased in patients with neoplasms. Low-grade mucinous adenoma (39.02%) was the most common neoplasm, followed by precancerous serrated adenoma (28.04%) and carcinoid tumor (21.95%), respectively. Moreover, the mean diameter of carcinoid tumors was 6.32±4.69 mm and 2 patients with >20 mm lesion diameter underwent right hemicolectomy. Carcinoid tumors were mostly located at the tip of the appendix. In addition, no lymphovascular invasion or distant metastasis was observed in any of the patients.Conclusion:Primary ANs are exceedingly rare and easily overlooked, the increased incidence of major complications such as perforation should be taken into consideration with AA-like clinical presentation in AN patients. Thus, preoperative laboratory and especially radiological outcomes should be carefully evaluated.

Keywords

• appendiceal neoplasms
• acute appendicitis
• carcinoid tumor
• low grade mucinous neoplasm