Should We Be Afraid Of Neuroendocrine Appendix Tumors?

Abstract

Introduction: Appendix neoplasms are rarely seen and usually detected by chance after appendectomy. Carcinoid tumors, also called neuroendocrine tumors, make up more than 50% of appendix tumors. Since the diagnosis is usually made as a result of examination of postoperative pathology specimens, patients should be followed up well after appendectomy. Material and Method: 820 appendectomies performed between 2016 and 2020 in Eskisehir Osmangazi University General Surgery Clinic were examined and the patients whose pathology results were appearing as appendix neoplasm were retrospectively analyzed. Results: Neoplastic lesions were detected in 22 of 820 patients. The most common tumoral lesions in the appendix are neuroendocrine tumors and were seen in 8 patients (0.9%) in our series. The average age of patients is 44.75. It was determined that 6 of the patients were male and 2 were female. The average tumor diameter was found to be 4.9 mm. Discussion: Among the appendix malignant tumors, neuroendocrine tumors are the most common. Apart from this, although rare, goblet cell carcinoma, lymphoma, mucocele, primary adenocarcinoma and mucinous cystadenocarcinoma are also seen. In our study, the incidence of neuroendocrine tumors in patients with appendectomy was 0.9%. In the literature, the rates on this issue range from 0.3% to 0.9%. In our study, the average age of patients with neuroendocrine tumors was determined to be 44.75 and is consistent with the literature. Appendix neuroendocrine tumors rarely metastasize. Carcinoid syndrome due to appendix carcinoid tumor is rare and is often associated with liver metastasis. Although serosal and intramural lymphatic invasion, tumors smaller than 2 cm in diameter can be treated with appendectomy and mesoapendix resection. Conclusion: Appendix neoplasms are generally diagnosed after examination of pathology specimens after appendectomy. Although their prognosis is good, they should be followed closely since the presence of synchronous and metachronous tumor is high.

Keywords: appendix, tumor, incidental

DOI: 10.7176/JHMN/78 05