Ýnsidental saptanan apendiks nöroendokrin tümörleri: Tek merkezin uzun dönem sonuçlarý

AMAÇ: Apendiks nöroendokrin tümörleri (NET), apendiksin en sýk görülen tümörleridir ve sýklýkla insidental olarak saptanýr. Bu çalýþmanýn amacý kliniðimizde insidental olarak taný konulmuþ apendiks NET’leri retrospektif olarak deðerlendirmektir.
GEREÇ VE YÖNTEM: Ocak 2009-Ocak 2022 tarihleri arasýnda Ankara Eðitim ve Araþtýrma Hastanesi Genel Cerrahi Kliniði’nde akut apandisit tanýsý ile apendektomi yapýlan 8304 hastanýn 33’ünün histopatolojik sonuçlarý apendiks NET olarak deðerlendirildi ve bu olgularýn retrospektif analizi yapýldý. Hastalar yaþ, cinsiyet, tümör infiltrasyonu, tümör yerleþimi, tümör boyutu, cerrahi sýnýr, Dünya Saðlýk Örgütü sýnýflamasýna göre grade, yapýlan cerrahi, lenf nodu metastazý, Ki67 indeksi, mitoz sayýsý, takip süresi ve saðkalým açýsýndan deðerlendirildi.
BULGULAR: Çalýþmada apendiks NET oraný %0.4 olarak bulundu.Taný alan 33 olgunun 15’i (%45.5) erkek ve 18’i (%54.5) kadýndý, hastalarýn yaþ ortalamasý 35.48 (16-84 arasý) idi. 1 olguda (%3.03) pozitif cerrahi sýnýr saptandý ve sað hemikolektomi gerçekleþtirildi. Diðer tüm olgular apendek-tomi sonrasý takibe alýndý. Medyan takip süresi 89 (7-145) aydý. Hiçbir olguda nüks gözlenmedi. Bir olguda takip sýrasýnda tümör dýþý nedenlere baðlý mortalite geliþti.
SONUÇ: Apendiks NET’ler genellikle asemptomatiktir ve akut apandisit nedeniyle yapýlan apendektomi sonrasý insidental olarak ortaya çýkar. Apendiks NET’ler genellikle 2 cm’nin altýndadýr ve iyi prognoza sahiptir.

Incidental presentation of appendix neuroendocrine tumor: Long-term results from a single institution

BACKGROUND: Appendix neuroendocrine tumors (NETs) are the most common tumors of the appendix and are most often diagnosed incidentally. The aim of this study was to retrospectively evaluate appendix NETs diagnosed incidentally in our clinic.
METHODS: Of 8304 patients who underwent appendectomy with the diagnosis of acute appendicitis in Ankara Training and Re-search Hospital, General Surgery Clinic between January 2009 and January 2022, 33 had histopathology results evaluated as appendix NET, and a retrospective analysis was made of these cases. The patients were evaluated in terms of age, gender, tumor infiltration, tumor location, tumor size, surgical margin, tumor World Health Organization grade, surgery performed, lymph node metastasis, Ki67 index, number of mitosis, follow-up time, and survival.
RESULTS: The rate of appendix NET was found to be 0.4%. The 33 cases comprised 15 (45.5%) males and 18 (54.5%) females with a mean age of 35.48 years (range: 16–84 years). Positive surgical margin was determined in 1 (3.03%) case, in which right hemicolectomy was performed. All other cases were followed up after appendectomy. The median follow-up was 89 (7–145) months. No recurrence was observed in any case. Mortality developed during follow-up in one case due to non-tumoral causes.
CONCLUSION: Appendix NETs are generally asymptomatic and appear incidentally after appendectomy due to acute appendicitis. Appendix NETs diagnosed incidentally are generally below 2 cm and have a good prognosis.