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Our Three Year Clinical Experience at Appendiceal Incidental Neoplasms and Management of Appendicial Tumors

Hançerlioğullari O, Kahraman Sd, Peker YS, Yilmaz M, Kilbaş Z, Menteş O, Kozak O, Günal A and Kiliç M

Appendectomy due to acute appendicitis is one of the most common emergency operations that is applied at the general surgery clinics and for this reason neoplasms of appendix may commonly be unforseen. Because unforseen neoplasms of the appendix may cause health problems for the patient and medicolegal problems for the surgeon, we decided to evaluate the histopathological results of the appendectomy specimens that were excised at our clinic between 2012 and 2015. 1332 patients were evaluated and 20 of them were found to have appendicial neoplasms of low-grade mucinous neoplasm in 9 (45%), appendiceal adenoma in 6 (30%), neuroendocrine tumor in 4 (20%) and metastases of gastric adenocarcinoma in 1 (5%) patient. Mean age of patients was 44.6 ± 14.41 years. 13 (65%) were male and 7 (35%) were female. The mean preoperative white blood cell count was 9645.0 ± 4490.3/ mmá¶ï¿½. 9 (45%) patient's appendix were able to be evaluated by preoperative abdominal ultrasound and the mean diameter of appendix was 10.65 ± 4.16 mm. None of the patients had meckel diverticulum. Appendectomy was performed to 19 (95%) patients and partial resection of caecum with appendectomy was performed to 1 (5%) patient.

The malignant tumors of appendix are adenocarcinomas, carcinoid tumors and extremely rare stromal tumors which they all may mimic acute appendicitis. Adenocarcinomas are belived to be more common than carcinoid tumors as it was not in past. Unforseen neoplasms of appendix may come up with peritoneal carcinomatosis with short survival and cause medicolegal problems for the surgeons. For this reason, surgeons must keep in mind that all appendix caused acute abdomen patients may not be acute appendicitis.