Dong XF, Ma ZH, Zhao YF. Primary malignant neoplasms of the appendix: An analysis of 8 cases.
Shijie Huaren Xiaohua Zazhi 2012;
20:2746-2750. [DOI:
10.11569/wcjd.v20.i28.2746]
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Abstract
AIM: To investigate the clinical and pathological characteristics, diagnosis, treatment and prognosis of primary malignant neoplasms of the appendix and to discuss how to reduce misdiagnosis and reoperation.
METHODS: A total of 442 patients with primary malignant neoplasms of the appendix were retrospectively analyzed, among them 8 were diagnosed at the Second Affiliated Hospital of Dalian Medical University and the other 434 were identified in Chinese medical literature databases.
RESULTS: Of 8 patients diagnosed at our hospital, 6 were male and 2 were female. Their average age at the time of presentation was 48.37 years (range 21-76 years). The duration of the disease was 10 h-8 d in 6 cases, 3 years in one case, and 20 years in one case. Postoperative pathology suggested carcinoid in 4 four cases and adenocarcinoma in other 4 cases. All of them were misdiagnosed preoperatively and intraoperatively. Six cases were followed, of whom four survived till now, one died, and one developed recurrence. Of 434 cases identified from Chinese literature, 220 were male and 214 were female. Their average age at the time of presentation was 45.14 years (mean 10-86 years). Only 2 patients were diagnosed preoperatively. Postoperative pathology suggested carcinoid in 287 cases, adenocarcinoma in 138 cases, malignant lymphoma in 6 cases, and leiomyosarcoma in 3 cases. The prognosis of appendix carcinoid was better than that of adenocarcinoma, malignant lymphoma and leiomyosarcoma.
CONCLUSION: Primary malignant neoplasms of the appendix are difficult to diagnose preoperatively, and the diagnosis relies mainly on intraoperative frozen section and postoperative pathology. Selection of reasonable surgery can improve prognosis by pathological type, neoplastic size, position of the disease, infiltration depth, and lymph node metastasis.
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