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Sahin N, Ozyalvac FT, Donmez T, Surek A, Sahin EA, Calis G, Bulut S, Aydin H, Kabuli HA, Gumusoglu AY. The incidence of incidental neoplasia in pathology samples of patient who underwent appendectomy due to acute appendicitis. A single center experience: 6446 cases. Ir J Med Sci 2024; 193:2669-2679. [PMID: 39230650 DOI: 10.1007/s11845-024-03793-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/18/2024] [Indexed: 09/05/2024]
Abstract
PURPOSE Appendectomy is the standard treatment of acute appendicitis. However, recent advancements have introduced medical treatment as a potential alternative. Within this context, it's important to recognize the rare occurrence of appendiceal tumors, often incidentally discovered during histopathological examination following appendectomy. Consequently, there's a concern about the possibility of overlooking appendiceal neoplasms, particularly in cases where conservative treatment for acute appendicitis is considered. METHODS The files of patients who underwent surgery for acute appendicitis between January 2015 and December 2023 and were diagnosed with neoplasia in their pathology reports were retrospectively registered. Demographic characteristics of the patients, laboratory and imaging features, details of the surgery performed, preoperative and intraoperative suspicion of neoplasm and data from pathology reports were collected and analyzed. RESULTS A total of 6446 patients were operated for acute appendicitis. Neoplasia was detected in the histopathological examination of 93 patients (1.44%). Acute appendicitis was diagnosed in 51.6% of the patients by computed tomography. Neoplasm suspicion was present in 9.7% of patients in preoperative imaging methods and in 6.5% of patients intraoperatively. Only appendectomy was performed in 94.5% of patients. The most common appendiceal neoplasm is neuroendocrine tumors (40.9%), followed by appendiceal mucinous neoplasm (29%), sessile serrated adenoma (15%), and adenocarcinoma (6.5%). CONCLUSION Although appendiceal neoplasms are relatively rare in proportion, they represent a significant numerical value due to the density of cases. Therefore, this information should be taken into consideration when evaluating treatment options for acute appendicitis.
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Affiliation(s)
- Nurettin Sahin
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Floor 4, Tevfik Saglam Street. Nr: 11, Istanbul, Bakirkoy, 34147, Turkey.
| | - Ferman Tevfik Ozyalvac
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Floor 4, Tevfik Saglam Street. Nr: 11, Istanbul, Bakirkoy, 34147, Turkey
| | - Turgut Donmez
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Floor 4, Tevfik Saglam Street. Nr: 11, Istanbul, Bakirkoy, 34147, Turkey
| | - Ahmet Surek
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Floor 4, Tevfik Saglam Street. Nr: 11, Istanbul, Bakirkoy, 34147, Turkey
| | - Emine Ayca Sahin
- Department of Emergency, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Goker Calis
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Floor 4, Tevfik Saglam Street. Nr: 11, Istanbul, Bakirkoy, 34147, Turkey
| | - Sezer Bulut
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Floor 4, Tevfik Saglam Street. Nr: 11, Istanbul, Bakirkoy, 34147, Turkey
| | - Husnu Aydin
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Floor 4, Tevfik Saglam Street. Nr: 11, Istanbul, Bakirkoy, 34147, Turkey
| | - Hamit Ahmet Kabuli
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Floor 4, Tevfik Saglam Street. Nr: 11, Istanbul, Bakirkoy, 34147, Turkey
| | - Alpen Yahya Gumusoglu
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Building A, Floor 4, Tevfik Saglam Street. Nr: 11, Istanbul, Bakirkoy, 34147, Turkey
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Gobishangar S, Gobinath S, Thevamirtha C, Sarmila S, Kasthuri S, Paramanathan S. Prevalence of Neuroendocrine Tumours (NET) in Patients Undergoing Appendicectomy for Acute Appendicitis: A Tertiary Care Study. Cureus 2023; 15:e50783. [PMID: 38239530 PMCID: PMC10795718 DOI: 10.7759/cureus.50783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Acute appendicitis is one of the common causes of acute abdomen in adults, which is managed widely with appendicectomy. Neuroendocrine tumours are the most common appendiceal tumours diagnosed incidentally on appendicectomy specimens. Methods Demographic data, presenting complaints, indications for appendicectomy, and the histology findings based on histopathological reports of the patients who have undergone appendicectomy for appendicitis at surgical units of Teaching Hospital, Jaffna, from 1st of January 2019 to 31st of December 2022 were retrospectively analyzed. Results Of the 1341 histopathology reports, 0.2% (n=3) were neuroendocrine tumours (NET). The mean age of the patients with NET was 48.6, and 66.6% of them were females. All three NETs identified in appendicectomy specimens were well differentiated and smaller than 2 cm. All three had negative resection margins and were managed only with appendicectomy. Conclusion NETs of the appendix are the commonest appendiceal neoplasms. The majority of them are diagnosed incidentally in appendicectomy specimens. Surgical management of the tumours is either by appendicectomy or hemicolectomy, which depends mainly on tumor size. Surgical decisions should be tailor-made to the patients based on multi-disciplinary team decisions.
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Affiliation(s)
| | | | | | | | | | - Shathana Paramanathan
- Surgery, University of Jaffna, Jaffna, LKA
- Health Sciences, Management and Science University, Kula Lampur, MYS
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