PurposeThe appendiceal disease is a frequent entity, with a non-negligible number of malignancies. There is an association of synchronous appendiceal tumors with other malignancies, therefore a routine appendectomy could be considered. The aim of our study is to analyze the number of cases of non-inflammatory appendiceal disease with unusual histopathological findings of appendix samples. Secondary aims are to analyze the recurrence and mortality of appendicular tumors.Methods A retrospective cohort study of all the appendectomy specimens in a period of time of 5 years was performed.ResultsA total of 1870 appendectomies were included. Non-inflammatory disease was found in 127 cases (5.5%) and malignant neoplasm in 33 patients (1.76%). Mucinous Cystoadenoma was the most common benign tumor, representing 33.3 % of total cases. The most common appendiceal neoplasm was adenocarcinoma (11 patients) and neuroendocrine tumors (22 patients). Acute appendicitis was the most frequent surgical indications in those patients. In the adenocarcinoma group, older patients were more frequent (p=0.003), as was the presence of abscess (p=0.016). From the appendiceal neoplasm, 30% (10 patients) had a synchronous colorectal or gynecological cancer. Five-year survival for adenocarcinoma and neuroendocrine tumors was 53.6 % (95% CI 51-94) and 45.5 % (95% CI 26-72) (p=0,373).ConclusionsHistopathological assessment of the appendix will allow early diagnosis of many unusual findings of the appendix. We recommend to considered routine appendectomy due to the high incidence of appendiceal tumors and a non-negligible number of synchronous colorectal and gynecological cancers.