Ulus Travma Acil Cerrahi Derg. 2022; 28(3): 352-360 | DOI: 10.14744/tjtes.2021.86032

Neoplasms of the appendix: Single institution and ten-year experiences results

Emine Yýldýrým¹, Murat Kegin¹, Muhammed Özdemir¹, Sibel Bektaþ², Zekeriya Pelen¹, Muzaffer Er^1
1Department of General Surgery, University of Health Sciences, Gaziosmanpasa Training and Research Hospital, Ýstanbul-Turkey
²Department of Pathology, University of Health Sciences, Gaziosmanpasa Training and Research Hospital, Ýstanbul-Turkey

BACKGROUND: Appendix neoplasms are rare tumors of the gastrointestinal system. Appendiceal adenocarcinoma, appendiceal mucinous neoplasm, and neuroendocrine tumors (NETs) are the most encountered appendix-related neoplasms. The patients are usually got diagnosed after histopathological examination. This study aimed to explore the epidemiology, pathological subtypes, and treatment modalities of appendix neoplasms.
METHODS: A retrospective examination was made with 2821 patients who underwent appendectomy between April 2010 and August 2020. Demographic, clinical, radiological, surgical findings, and histopathological results were collected from the patient files.
RESULTS: Appendix neoplasms were detected in 1.06% of the patients included in the study. The mean age was 44.6±17.5 (17–83) years. Eight NETs, seven adenocarcinomas, fourteen mucinous neoplasms, and one neuroma were diagnosed with patients.
CONCLUSION: Appendiceal neoplasms are generally asymptomatic and often diagnosed with postoperative histopathological ex-amination. If the result is adenocarcinoma, right hemicolectomy recommends. Treatment of NETs depends on factors such as tumor size, location, mesoappendix invasion, and lymph node involvement. In the presence of mucinous neoplasm, surgical intervention is determined according to the pathological subtype and involvement of mesoappendix. The need for additional surgical intervention or medical treatment for patients with tumor, histopathological results must be followed carefully after appendectomy.

Keywords: Appendiceal adenocarcinoma, appendiceal mucinous neoplasm, appendiceal neoplasm, appendiceal neuroendocrine tumor.

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Appendiks neoplazmlarý: Tek merkez ve on yýllýk deneyim sonuçlarý

Emine Yýldýrým¹, Murat Kegin¹, Muhammed Özdemir¹, Sibel Bektaþ², Zekeriya Pelen¹, Muzaffer Er^1
1Saðlýk Bilimleri Üniversitesi Gaziosmanpaþa Eðitim ve Araþtýrma Hastanesi, Genel Cerrahi Anabilim Dalý, Ýstanbul
²Saðlýk Bilimleri Üniversitesi Gaziosmanpaþa Eðitim ve Araþtýrma Hastanesi, Patoloji Anabilim Dalý, Ýstanbul

AMAÇ: Appendiks neoplazileri gastrointestinal sistemin nadir görülen tümörleridir. Bunlar içinde adenokanser, musinoz neoplazm ve nöroendokrin tümörler sýk olarak karþýmýza çýkar. Taný genellikle ameliyat sonrasý histopatolojik inceleme sonrasý konur. Bu çalýþmada, insidental olarak taný konan appendiks neoplazilerinin epidemiyolojisini, patolojik subtiplerini ve tedavi modalitelerini araþtýrmayý amaçladýk.
GEREÇ VE YÖNTEM: Nisan 2010–Aðustos 2020 tarihleri arasýnda apendektomi yapýlan 2821 hasta geriye dönük olarak deðerlendirildi. Hastalarýn demografik verileri, ameliyat öncesi klinik ve radyolojik bulgularý, ameliyat bulgularý, histopatoloji sonuçlarý, ek ameliyat ve týbbi tedavi uygulamalarý geriye dönük olarak hasta dosyalarýndan toplandý.
BULGULAR: Çalýþmaya dahil edilen hastalarýn %1.06’sýnda appendiks neoplazmý saptandý. Ortalama yaþ 44.6±17.5 (daðýlým, 17–83) olarak bulundu. Hastalardan sekizi nöroendokrin tümör, yedisi adenokanser, ondördü müsinöz neoplazi ve biri nöroma tanýsý almýþtý.
TARTIÞMA: Appendiks neoplazileri genellikle asemptomatik ve sýklýkla ameliyat sonrasý histopatolojik inceleme ile taný alan tümörlerdir. Patoloji adenokanser ise tedavide sað hemikolektomi önerilirken nöroendokrin tümörlerin tedavisi tümör boyutu, yerleþimi, mezoappendiks invazyonu ve lenf nodu tutulumu gibi faktörlerden etkilenir. Musinöz neoplazm varlýðýnda patolojik alt tipe ve tutuluma göre cerrahi yöntem belirlenir. Patolojik inceleme sonucu tümör saptanan hastalarda ek tedavi ve takip gereksinimi apendektomi sonrasý histopatolojik sonucun takip edilmesi gerekliliðini bir kez daha vurgulamaktadýr.

Anahtar Kelimeler: Appendiks adenokanseri, appendiks neoplazmý, musinöz neoplazi, nöroendokrin tumor.

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