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Ozdemir H, Ozdemir ZU, Gul MO. Incidental appendiceal neoplasms: Single-centre results. Indian J Cancer 2023; 60:542-547. [PMID: 38159212 DOI: 10.4103/ijc.ijc_450_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/11/2020] [Indexed: 01/03/2024]
Abstract
BACKGROUND Histopathological examination of appendectomy specimens may reveal malignancies. Based on these results, either appendectomy is sufficient or sometimes a further treatment protocol can be needed. In this study, malignancy-diagnosed cases on appendectomy specimen were examined. METHODS Patients who underwent appendectomy between January 2013 and December 2018 with a pre-diagnosis of acute appendicitis were evaluated retrospectively and those cases with malignancy were included in the study. Patients' age, sex, tumor type, tumor diameter, tumor grade, tumor localization, surgical margin, Ki-67 index, state of lymphovascular invasion, state of peri-neural invasion, and follow-up period duration were recorded. RESULTS On examination of 2336 appendectomy specimens, 16 patients (0.7%) were found to have neuroendocrine tumors (NET), 11 patients (0.5%) were found to have low-grade mucinous neoplasm (LAMN), and five patients (0.2%) were found to have primary appendix carcinomas. Appendix tumors usually present with acute appendicitis symptoms. Despite re-operation with right hemicolectomy (RHC) being required in the treatment of adenocarcinoma cases, appendectomy provides adequate treatment in most cases with NET and LAMN. With these tumors, which usually have a benign prognosis, it is important to perform the necessary screening in the postoperative period and not to interrupt follow-up.
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Affiliation(s)
- Hakan Ozdemir
- Haydarpasa Numune Training and Research Hospital, General Surgery Department, Istanbul, Turkey
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2
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Núñez-Rocha RE, Girón F, Rodríguez L, Camargo-Gómez D, Restrepo-Bonilla C, Panqueva RDPL, Cadena M, Nassar R, Herrera-Almario GE, Hernández-Restrepo JD. Incidence of appendiceal neoplasms in appendectomy patients. BMC Surg 2023; 23:287. [PMID: 37735406 PMCID: PMC10512515 DOI: 10.1186/s12893-023-02183-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/04/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Non-operative management has been suggested as a therapy for uncomplicated appendicitis. Notwithstanding, the risk of missing an appendiceal tumor must be considered, being the surgical piece crucial to rule out neoplasms. Therefore, we aim to determine the incidence of appendiceal neoplasms in patients with acute appendicitis, tumor types and the importance of the anatomopathological study of the surgical piece. STUDY DESIGN Retrospective study in which we described patients who underwent emergent appendectomy with histopathological findings of appendiceal neoplasms from January 2012 to September 2018. Descriptive analysis included demographic variables, diagnostic methods, and surgical techniques. RESULTS 2993 patients diagnosed with acute appendicitis who underwent an emergency appendectomy. 64 neoplasms of the appendix were found with an incidence of 2,14%. 67.2% were women, the mean age was 46,4 years (± 19.5). The most frequent appendiceal neoplasms were neuroendocrine tumors (42,2%), followed by appendiceal mucinous neoplasms (35,9%), sessile serrated adenomas (18,8%), and adenocarcinomas (3,1%). In 89,1% of the cases, acute appendicitis was determined by imaging, and 14% of cases were suspected intraoperatively. Appendectomy was performed in 78,1% without additional procedures. CONCLUSIONS Appendiceal tumors are rare and must be ruled out in patients with suspected acute appendicitis. The incidence of incidental neoplasms is higher in this study than in the previously reported series. This information must be included in decision-making when considering treatment options for acute appendicitis.
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Affiliation(s)
- Ricardo E Núñez-Rocha
- Hospital Universitario Fundación Santa Fe de Bogotá, Calle 119 No. 7-14, Bogotá, DC, Colombia
- School of Medicine, Universidad de los Andes, Cundinamarca, Colombia
| | - Felipe Girón
- Hospital Universitario Fundación Santa Fe de Bogotá, Calle 119 No. 7-14, Bogotá, DC, Colombia.
- School of Medicine, Universidad de los Andes, Cundinamarca, Colombia.
| | - Lina Rodríguez
- School of Medicine, Universidad de los Andes, Cundinamarca, Colombia
| | | | | | - Rocío Del Pilar López Panqueva
- Hospital Universitario Fundación Santa Fe de Bogotá, Calle 119 No. 7-14, Bogotá, DC, Colombia
- School of Medicine, Universidad de los Andes, Cundinamarca, Colombia
| | - Manuel Cadena
- Hospital Universitario Fundación Santa Fe de Bogotá, Calle 119 No. 7-14, Bogotá, DC, Colombia
- School of Medicine, Universidad de los Andes, Cundinamarca, Colombia
| | - Ricardo Nassar
- Hospital Universitario Fundación Santa Fe de Bogotá, Calle 119 No. 7-14, Bogotá, DC, Colombia
- School of Medicine, Universidad de los Andes, Cundinamarca, Colombia
| | - Gabriel E Herrera-Almario
- Hospital Universitario Fundación Santa Fe de Bogotá, Calle 119 No. 7-14, Bogotá, DC, Colombia
- School of Medicine, Universidad de los Andes, Cundinamarca, Colombia
| | - Juan David Hernández-Restrepo
- Hospital Universitario Fundación Santa Fe de Bogotá, Calle 119 No. 7-14, Bogotá, DC, Colombia
- School of Medicine, Universidad de los Andes, Cundinamarca, Colombia
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3
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Tan JKT, Wong JSM, Seo CJ, Lim C, Zhu HY, Ong CAJ, Chia CS. Incidence and outcomes of delayed presentation and surgery in peritoneal surface malignancies. Front Oncol 2023; 13:1137785. [PMID: 37324005 PMCID: PMC10265672 DOI: 10.3389/fonc.2023.1137785] [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] [Received: 01/04/2023] [Accepted: 05/18/2023] [Indexed: 06/17/2023] Open
Abstract
Background Peritoneal surface malignancies (PSM) present insidiously and often pose diagnostic challenges. There is a paucity of literature quantifying the frequency and extent of therapeutic delays in PSM and its impact on oncological outcomes. Methods A review of a prospectively maintained registry of PSM patients undergoing Cytoreductive Surgery and Hyperthermic Intra-peritoneal Chemotherapy (CRS-HIPEC) was conducted. Causes for treatment delays were identified. We evaluate the impact of delayed presentation and treatment delays on oncological outcomes using Cox proportional hazards models. Results 319 patients underwent CRS-HIPEC over a 6-years duration. 58 patients were eventually included in this study. Mean duration between symptom onset and CRS-HIPEC was 186.0 ± 37.1 days (range 18-1494 days) and mean duration of between patient-reported symptom onset and initial presentation was 56.7 ± 16.8 days. Delayed presentation (> 60 days between symptom onset and presentation) was seen in 20.7% (n=12) of patients and 50.0% (n=29) experienced a significant treatment delay of > 90 days between 1st presentation and CRS-HIPEC. Common causes for treatment delays were healthcare provider-related i.e. delayed or inappropriate referrals (43.1%) and delayed presentation to care (31.0%). Delayed presentation was a significantly associated with poorer disease free survival (DFS) (HR 4.67, 95% CI 1.11-19.69, p=0.036). Conclusion Delayed presentation and treatment delays are common and may have an impact on oncological outcomes. There is an urgent need to improve patient education and streamline healthcare delivery processes in the management of PSM.
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Affiliation(s)
- Jun Kiat Thaddaeus Tan
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
| | - Jolene Si Min Wong
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- SingHealth Duke-NUS Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- SingHealth Duke-NUS Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Chin Jin Seo
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- SingHealth Duke-NUS Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- SingHealth Duke-NUS Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Cindy Lim
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre Singapore, Singapore, Singapore
| | - Hong-Yuan Zhu
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
| | - Chin-Ann Johnny Ong
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- SingHealth Duke-NUS Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- SingHealth Duke-NUS Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Laboratory of Applied Human Genetics, Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, Singapore
- Institute of Molecular and Cell Biology, A*STAR Research Entitie, Singapore, Singapore
| | - Claramae Shulyn Chia
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumors (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- SingHealth Duke-NUS Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- SingHealth Duke-NUS Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
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Ruiz SG, Geraghty F, Padron D, Chacon D, Kahane G. The Appendix: A Rare Case of an Appendiceal Collision Tumor. Cureus 2021; 13:e17050. [PMID: 34522528 PMCID: PMC8428163 DOI: 10.7759/cureus.17050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2021] [Indexed: 11/12/2022] Open
Abstract
Appendicitis is a common cause of right lower quadrant pain. However, appropriate diagnostic evaluation and a high clinical suspicion can reveal alternative etiologies that are not so commonly encountered. In this report, we present a rare case of an appendiceal collision tumor involving two distinct neoplasms as the source of the patient's pain and describe how thoughtful clinical maneuvering led to its diagnosis and treatment.
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Affiliation(s)
- Samuel G Ruiz
- General Surgery, Kendall Regional Medical Center, Miami, USA
| | | | - Dalina Padron
- Anesthesiology, Mount Sinai Medical Center of Florida, Miami Beach, USA
| | | | - Gerardo Kahane
- General Surgery, Aventura Hospital and Medical Center, Aventura, USA
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5
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Khor Ee IH, Chor Lip HT, Muniandy J. Appendiceal mucinous neoplasm. ANZ J Surg 2021; 92:595-597. [PMID: 34324784 DOI: 10.1111/ans.17107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 07/18/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Ivan Ho Khor Ee
- Colorectal Unit, Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia
| | - Henry Tan Chor Lip
- Colorectal Unit, Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia
| | - Jothinathan Muniandy
- Colorectal Unit, Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia
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Nikou AF, Tenzel NS, Hua P, Orbuch L, Orbuch IK. Appendectomy Should Be Performed During Minimally Invasive Surgery for Endometriosis. JSLS 2021; 25:JSLS.2020.00095. [PMID: 33880001 PMCID: PMC8035829 DOI: 10.4293/jsls.2020.00095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Objectives: To determine the prevalence of appendiceal histopathology in patients with confirmed endometriosis following minimally invasive surgery (MIS) for endometriosis. To determine whether pre-operative symptoms, age, intra-operative appendiceal appearance, or endometrioma laterality were associated with appendix histopathology in patients with suspected endometriosis. Methods: One hundred thirty-five patients ages 16–52 with suspected endometriosis undergoing MIS for endometriosis with concomitant appendectomy at two metropolitan academic hospitals from January 1, 2012 to June 30, 2017 were included in this retrospective chart-review study. Medical records were reviewed for pre-operative symptoms, age, intraoperative appendix appearance, appendix histopathology, histopathologically-confirmed endometriosis, and endometriomas. Results: In patients with confirmed endometriosis, the prevalence of all appendiceal histopathology was 25%, which included appendiceal endometriosis (18%), appendiceal tumors (2%), and inflammation (5%). Dyspareunia was the only pre-operative symptom significantly associated with appendiceal histopathology (p = 0.04). The presence of a right endometrioma was associated with appendiceal histopathology (p = 0.009). Additionally, appendiceal histopathology was not significantly associated with age nor intra-operative appendiceal characteristics. Conclusion: This manuscript adds to the limited pool of studies regarding appendiceal histopathology and appendiceal tumors in patients with suspected and confirmed endometriosis. On the basis of the high rate of histopathological appendices found in this population; the lack of association with possible diagnostic factors such as age, most pre-operative symptoms, and intra-operative appendiceal characteristics; and the relatively low risks of concomitant appendectomy, we suggest that surgeons consider concomitant appendectomies at the time of MIS for endometriosis.
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Affiliation(s)
| | - Nicole Sara Tenzel
- Obstetrics, Gynecology, and Reproductive Science, Mt Sinai Health System, New York, NY
| | - Peiying Hua
- Population Health Science and Policy, Icahn School of Medicine at Mt Sinai, New York, NY
| | - Laurence Orbuch
- Obstetrics, Gynecology, and Reproductive Science, Mt Sinai Health System, New York, NY
| | - Iris Kerin Orbuch
- Obstetrics, Gynecology, and Reproductive Science, Mt Sinai Health System, New York, NY
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7
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Borges AL, Reis-de-Carvalho C, Chorão M, Pereira H, Djokovic D. Low-grade mucinous appendiceal neoplasm mimicking an ovarian lesion: A case report and review of literature. World J Clin Cases 2021; 9:2334-2343. [PMID: 33869611 PMCID: PMC8026829 DOI: 10.12998/wjcc.v9.i10.2334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/04/2021] [Accepted: 02/11/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Appendiceal tumors are rare lesions that may not be easily differentiated from primary ovarian lesions preoperatively, despite the use of advanced diagnostic methods by experienced clinicians.
CASE SUMMARY A 59-year-old G2P2 woman, with chronic pelvic pain, underwent a pelvic ultrasound that revealed an adnexal mass measuring 58 mm × 34 mm × 36 mm, with irregular borders, heterogeneous echogenicity, no color Doppler vascularization and without acoustic shadowing. Normal ovarian tissue was visualized in contact with the lesion, and it was impossible to separate the lesion from the ovary by applying pressure with the ultrasound probe. Ascites, peritoneal metastases or other alterations were not observed. With the international ovarian tumor analysis ADNEX model, the lesion was classified as a malignant tumor (the risk of malignancy was 27.1%, corresponding to Ovarian-Adnexal Reporting Data System category 4). Magnetic resonance imaging confirmed the presence of a right adnexal mass, apparently an ovarian tumor measuring 65 mm × 35 mm, without signs of invasive or metastatic disease. During explorative laparotomy, normal morphology of the internal reproductive organs was noted. A solid mobile lesion involved the entire appendix. Appendectomy was performed. Inspection of the abdominal cavity revealed no signs of malignant dissemination. Histopathologically, the appendiceal lesion corresponded to a completely resected low-grade mucinous appendiceal neoplasm (LAMN).
CONCLUSION The appropriate treatment and team of specialists who should provide health care to patients with seemingly adnexal lesions depend on the nature (benign vs malignant) and origin (gynecological vs nongynecological) of the lesion. Radiologists, gynecologists and other pelvic surgeons should be familiar with the imaging signs of LAMN whose clinical presentation is silent or nonspecific. The assistance of a consultant specializing in intestinal tumors is important support that gynecological surgeons can receive during the operation to offer the patient with intestinal pathology an optimal intervention.
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Affiliation(s)
- André Luís Borges
- Department of Obstetrics and Gynecology, Hospital de São Francisco Xavier-Centro Hospitalar Lisboa Ocidental, Lisbon 1449-005, Portugal
- Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã 6201-001, Portugal
| | - Catarina Reis-de-Carvalho
- Department of Obstetrics, Gynecology and Reproductive Medicine, Hospital de Santa Maria-Centro Hospitalar Universitário Lisboa Norte, Lisbon 1649-028, Portugal
| | - Martinha Chorão
- Department of Pathology, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon 1349-019, Portugal
| | - Helena Pereira
- Department of Obstetrics and Gynecology, Hospital de São Francisco Xavier-Centro Hospitalar Lisboa Ocidental, Lisbon 1449-005, Portugal
| | - Dusan Djokovic
- Department of Obstetrics and Gynecology, Maternidade Dr. Alfredo da Costa-Centro Hospitalar Universitário de Lisboa Central, Lisbon 2890-495, Portugal
- Faculdade de Ciências Médicas, Nova Medical School, Lisbon 1169-056, Portugal
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8
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Koç C, Akbulut S, Akatlı AN, Şamdancı ET, Tuncer A, Yılmaz S. Nomenclature of appendiceal mucinous lesions according to the 2019 WHO Classification of Tumors of the Digestive System. THE TURKISH JOURNAL OF GASTROENTEROLOGY : THE OFFICIAL JOURNAL OF TURKISH SOCIETY OF GASTROENTEROLOGY 2020; 31:649-657. [PMID: 33090102 PMCID: PMC7577417 DOI: 10.5152/tjg.2020.20537] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND/AIMS To analysis the appendiceal mucinous lesions according to the World Health Organization (WHO) 2019 classification of tumors of the digestive system (non-neuroendocrine tumors of the appendix vermiformis) MATERIALS AND METHODS Clinical and histopathological data of 37 patients with histopathologically proven appendiceal mucinous lesion from January 2010 to May 2019 were evaluated retrospectively. Pathology slides were re-evaluated by two pathologists according to the WHO 2019 classification of tumors of the digestive system. RESULTS Totally 37 patients (male:19 female: 18) aged 23 to 93 years were analyzed. Majority of the patients (75.7 %) had underwent appendectomy due to preliminary diagnosis of acute appendicitis (n=22) or periappendiceal tumoral lesions (n=9), the others (n=9) underwent incidental appendectomy. Whereas acute appendicitis was histopathologically diagnosed in 16 (43.2%) patients, perforation was diagnosed in 12 (32.4%) patients (perforation without appendicitis=3, perforation with appendicitis=6). According to the initial, pathology reports were prepared as follows: mucocele (n=10), mucinous cystadenoma (n=9), low-grade mucinous neoplasm (n=6), mucinous adenocarcinoma (n=5), mucosal hyperplasia (n=5), hyperplastic polyp (n=1), adenomatous polyp (n=1). On the basis of the WHO 2019 classification, pathology reports were prepared as follows: low-grade mucinous neoplasm (n=17), simple retention cysts (n=6), hyperplastic polyp (n=6), mucinous adenocarcinoma (n=5), ruptured appendiceal diverticula (n=2), sessile serrated lesion (n=1). CONCLUSION The term of appendiceal mucinous lesion, which is recently introduced into medical literature is suitable to distinguish between lesions with and without malignancy potential. The WHO 2019 classification system has been an important step in simplifying the classification of non- neuroendocrine tumors of the appendix vermiformis.
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Affiliation(s)
- Cemalettin Koç
- Department of Surgery and Liver Transplant Institute, İnönü University School of Medicine, Malatya, Turkey
| | - Sami Akbulut
- Department of Surgery and Liver Transplant Institute, İnönü University School of Medicine, Malatya, Turkey
| | - Ayşe Nur Akatlı
- Department of Pathology, İnönü University School of Medicine, Malatya, Turkey
| | | | - Adem Tuncer
- Department of Surgery and Liver Transplant Institute, İnönü University School of Medicine, Malatya, Turkey
| | - Sezai Yılmaz
- Department of Surgery and Liver Transplant Institute, İnönü University School of Medicine, Malatya, Turkey
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9
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Abdel-Rahman O. Impact of cytoreductive surgery on outcomes of metastatic appendiceal carcinoma: a real-world, population-based study. J Comp Eff Res 2020; 9:431-439. [PMID: 32253936 DOI: 10.2217/cer-2019-0179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To evaluate the impact of cytoreductive surgery on the outcomes of patients with metastatic appendiceal carcinoma. Methods: Surveillance, Epidemiology and End Results (SEER) database was accessed and patients with metastatic appendiceal carcinoma diagnosed (2010-2015) were reviewed. Kaplan-Meier survival estimates/log-rank testing were then used to assess overall survival outcomes according to cytoreductive surgery. Multivariable Cox regression analysis was then used to evaluate factors affecting cancer-specific survival. Factors included in this model were age, race, sex, stage and histology and cytoreductive surgery. Results: A total of 1339 patients with metastatic appendiceal carcinoma were included in the current study. Using Kaplan-Meier survival estimates to evaluate overall survival, patients with surgery for metastatic disease have better overall survival compared with patients without surgery for metastatic disease (p < 0.001). Stratifying survival analysis according to histology, the overall survival benefit from surgery for the metastases seems to be limited to patients with mucinous adenocarcinoma (p = 0.002) rather than patients with nonmucinous adenocarcinoma (p = 0.401). Multivariable Cox regression analysis was then conducted to evaluate factors predicting cancer-specific survival. The following factors were associated with worse cancer-specific survival: African-American race (hazard ratio [HR]: 1.356; 95% CI: 1.036-1.774; p = 0.026), more advanced stage (HR: 3.910; 95% CI: 2.735-5.588; p < 0.001), nonmucinous adenocarcinoma (HR for signet ring carcinoma vs mucinous adenocarcinoma: 2.119; 95% CI: 1.674-2.683; p < 0.001) and no surgical resection of metastatic disease (HR: 1.273; 95% CI: 1.067-1.519; p < 0.001). Conclusion: The current study suggests that among patients with metastatic appendiceal carcinoma, surgical cytoreduction of metastatic disease is associated with improved outcomes for patients with mucinous adenocarcinoma but not in patients with nonmucinous adenocarcinoma.
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Affiliation(s)
- Omar Abdel-Rahman
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, T6G 1Z2, Canada
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10
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Virgilio BA, Pontrelli G, Trevisan P, Sacchi D, Bernardini T, Scioscia M. Incidental diagnosis on transvaginal ultrasound of appendiceal mucocele arising on low-grade appendiceal mucinous neoplasm. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2019; 54:412-414. [PMID: 30353587 DOI: 10.1002/uog.20158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 10/13/2018] [Accepted: 10/15/2018] [Indexed: 06/08/2023]
Affiliation(s)
- B A Virgilio
- Department of Obstetrics and Gynecology, Policlinico of Abano Terme, Abano Terme, Padua, Italy
| | - G Pontrelli
- Department of Obstetrics and Gynecology, Policlinico of Abano Terme, Abano Terme, Padua, Italy
| | - P Trevisan
- Department of Surgery, Policlinico of Abano Terme, Abano Terme, Padua, Italy
| | - D Sacchi
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padova, Padua, Italy
| | - T Bernardini
- Department of Obstetrics and Gynecology, Policlinico of Abano Terme, Abano Terme, Padua, Italy
| | - M Scioscia
- Department of Obstetrics and Gynecology, Policlinico of Abano Terme, Abano Terme, Padua, Italy
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Raposo Rodríguez L, Fernández García N, Tovar Salazar D, Gómez Illán R, Díaz Sánchez T. Imaging findings for mucinous tumors tumortumorof the abdomen and pelvis. RADIOLOGIA 2019. [DOI: 10.1016/j.rxeng.2019.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Imaging findings for mucinous tumors of the abdomen and pelvis. RADIOLOGIA 2019; 61:370-387. [PMID: 31078302 DOI: 10.1016/j.rx.2019.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 02/25/2019] [Accepted: 03/15/2019] [Indexed: 11/23/2022]
Abstract
This article aims to describe the imaging findings for mucinous tumors of the abdomen and pelvis, which have a similar appearance on imaging tests regardless of the organ in which they develop. Due to the high water content of mucus, the appearance of these tumors is generally similar to that of water on ultrasonography, computed tomography, and magnetic resonance imaging. Another common feature of mucin-producing tumors is that calcifications are often present. The rupture of these lesions and accumulation of mucinous material in the peritoneal cavity gives rise to pseudomyxoma peritonei. It is important to identify mucinous tumors because they have a different prognosis and clinical course than non-mucinous tumors and require different management. Depending on their anatomic location and their imaging characteristics, the treatment approach varies from follow-up to radical surgery together with chemotherapy or radiotherapy or both.
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