Background: Goblet cell carcinoids (GCC) and other atypical neuroendocrine tumors (NET) of the appendix as well as appendiceal adenocarcinoma are usually managed with the same algorithm as colon cancers. This study investigates clinicopathological features that are predictive of survival outcomes for appendiceal NET and adenocarcinoma. Survival profiles for the histologic subtypes of appendiceal NET and adenocarcinoma were compared. Methods: A retrospective review of appendiceal NET and adenocarcinoma for patients who are 18 years and above in the SEER database from 2010 to 2014. Results: Females outnumbered males in a 1.3 to 1 ratio in the NET subgroup and 1.1 to 1 ratio in the adenocarcinoma group. The mean age at diagnosis for all NET was 50.3±17 years while that of adenocarcinomas was 60.8±14.1 years. Within the NET subgroups, the mean ages for typical carcinoids (TC), GCC, NEC and MANEC were 42.9±17.3, 56.7±13.7, 45.6±17.4 and 59.7±12.8 years, respectively. Overall survival for adenocarcinoma was 86.3%, 73.5%, 65.7%, and 57.6% for 1-, 2-, 3-and 4-year OS, respectively. For NET, TC showed better survival profile with 1-and 4-year overall survival of 97.4% and 95.7%, respectively while MANEC had the worst survival outcome with 1-and 4-year OS of 88.6% and 62.2%, respectively. GCC had a better 1-year OS compared to NEC (95.5% versus 92.9%) but showed slightly worse 4-year OS (82% versus 84.8%). Age at diagnosis (HR 1.03), African-American race (HR 1.47) and stage IV disease (HR 9.58) were independent predictors of survival for appendiceal adenocarcinoma. For NET, advanced age at diagnosis, advanced disease stage and the African-American race were identified as negative independent predictors of survival. Conclusions: While prior studies have suggested that atypical NET (GCC, NEC and MANEC) are more likely to present at more advanced stages, this study showed that most cases of GCC, MANEC and NEC were diagnosed at stages I and II. Appendiceal adenocarcinoma, on the other hand, presented mostly at stage IV. With respect to OS, atypical histologic subtypes of NET have worse outcome compared to TC. Although better OS was noted for GCC, NEC and MANEC when compared to adenocarcinoma, this benefit was lost in stage IV disease where adenocarcinoma recorded better 1-and 4-year OS. Prospective and randomized studies which provide granular details of treatment are needed to better define treatment algorithm for appendiceal NET.

Highlights EF should be considered when subepithelial tumor is associated with dysphagia. Preop diagnosis is enhanced by needle biopsy with IHC analysis. S100 was the most utilized IHC stain. Enucleation (39.3%) was the most common treatment. MIS treatment is feasible.

HighlightsPleomorphic Hyalinizing Angiectatic Tumors are rare tumors.Diagnosis is best with microscopic and histochemical analysis.Treatment is with wide local resection.

HighlightsA case report of a Brenner tumor incidentally associated with a mucinous ovarian tumor is presented.The frozen section was diagnosed as benign and the Brenner’s tumor was noted.Final pathological report revealed borderline classification of tumor.It is unknown whether an associated Brenner’s tumor increases risk of malignancy.A better understanding of this relationship could help guide intraoperative decision making.

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Adrenal oncocytomas and retroperitoneal schwannomas are two groups of very rare tumors with distinct histologic features. Both tumors are usually incidentally found and are mostly benign. Optimal management is usually with surgical resection. We report a unique case of a 74-year-old woman who was incidentally found to have these two exceptionally rare tumors at the same time. She was successfully managed with surgical resection of the retroperitoneal schwannoma and adrenalectomy for the adrenal oncocytoma and both diagnoses were confirmed with histopathology and immunochemistry.

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The purpose of the Armenian Global Health program is to create collaborations between health organizations to allow better access to medicine for Armenians. The program had the opportunity to host the first Armenian Global Health Conference at Yerevan State Medical School. Prior to this conference, the program conducted meetings with Armenian dignitaries to determine which medical concerns are the top priority to Armenians. Armenians chose to focus on how to prevent and treat chronic diseases. Design and Methodology:The World Health Organization estimated that 55.5% of Armenian adults were overweight and 24% were obese in 2008 (1). Obesity is the largest contributor to preventable chronic diseases such as diabetes and hypertension. The Global Health Armenia program at the University of Utah collaborated with the Ministry of Health of Armenia and Yerevan State Medical University to reach over 517 men and women between the ages of 18 and 89. Outreach events were open to the public and held at medical centers in Gyumri, Dilijan, Ararat, Yerevan, and Sevan during the summer of 2015.