MALIGNANT TUMORS OF THE APPENDIX:EVALUATION OF 6748 APPENDECTOMY CASES

Abstract

Objective: Appendiceal neoplasms are usually diagnosed incidentally after appendectomy for the treatment of acute appendicitis. This study aimed to present incidental malignancy cases that we detected retrospectively by examining our appendectomy results. Materials and Methods: 6748 appendectomy cases performed in Van Research and Training Hospital, Department of Surgery, Turkey, between January 2016 and January 2020, were retrospectively analyzed. After histopathological analysis, 22 patients were found to have low-grade appendiceal mucinous neoplasia (LAMN) and appendiceal neuroendocrine tumors (NET). The complete data of the patients were recorded, including the demographic, laboratory, imaging, and histopathological data. Results: The median age of 22 patients included in the study was 39 years (18-72 years), and 14 (63.6%) were women. Malignancy was suspected in only 4 (18%) patients during exploration. Histologically, the tumor was located distally in 19 (83.4%) patients and was located at the base of the appendix in 3 patients. Histopathological analysis; resulted as grade 1 NET in 15 patients, LAMN in 5 patients, grade 2 NET in 1 patient, and mixed type (mucinous + neuroendocrine tumor) in 1 patient. The Median follow-up time was 45.5 months (range: 26-53). During the follow-up, one of our patients who underwent right hemicolectomy due to the tumor at the surgical margin was diagnosed with pseudomyxoma peritonei. Conclusion: Appendiceal neoplasms are often diagnosed in the results of postoperative pathological examinations. In patients with suspected malignancy during the perioperative examination, it is crucial to carefully examine intra-abdominal organs and avoid surgical margin positivity. Malignancy risks should always be kept in mind in non-routine appendix appearances.