Appendiceal Neuroendocrine Tumours – Experience of One Service

Abstract

Tumours of the appendix are rare and tend to be diagnosed incidentally, in cases of acute appendicitis. For some authors, appendiceal neuroendocrine tumours (ANETs) are the most frequent neoplasm of the appendix, observed in 0.3% to 0.9% of cases acute appendicitis. The present is a unicentric retrospective study conducted between January 2005 and March 2017. Out of a total of 3,007 surgeries for appendiceal pathologies performed in the adult population at the hospital where the present study was conducted, there were 70 (2.33%) malignant cases, 20 (28.6%) of which were ANETs. The patients had a median age of 44 years (range: 18 to 85 years), and were predominantly women (there were 1.9 times more women than men). In 16 cases (80%), a simple appendicectomy was performed (1 patient was submitted to a right hemicolectomy later). The cases of ANETs had a good prognosis in our series: 85% of the patients are either alive today or were alive after 5 years of follow-up. Despite the fact that ANETs are described as the most frequent tumor of the appendix, this was not confirmed in our series, in which they only represented 28.6% of the cases; adenocarcinoma was the most frequent tumor (65.7%) among our sample.

Factors Affecting Survival Outcomes in Neuroendocrine Tumor of the Appendix over the Past Two Decades

“…These tumors are further classified as epithelial and non-epithelial tumors. The non-epithelial appendiceal tumors include lymphomas and appendiceal neuroendocrine tumors (aNETs) [1]. aNETs are the most common tumors of the appendix and account for 0.5-1% of intestinal tumors [2].…”

“…More than 80% of the cases of aNETs are diagnosed incidentally [3]. These tumors are island-like or tubular carcinoids that originate from neuroendocrine cells [1]. In recent decades, neuroendocrine tumors of the appendix have become more common due to improvements in the classification system, the presence of more developed imaging modalities, and a better understanding of the pathophysiology of these tumors [4].…”

“…aNETs smaller than 20 mm can be eliminated by simple appendectomy and have less chance of recurrence and metastasis. If the tumor is larger than 20 mm, more aggressive interventions are required for its treatment [1]. Lympho-vascular invasion is another significant factor for the treatment of aNETs.…”

“…Other therapies include targeted therapies and cytotoxic chemotherapy [20,21]. The prognosis of aNETs is generally good, and the survival rate is 5 years in more than 90% of the cases [1]. Follow-up depends on the type of surgery and the features of the tumor.…”

Análise Comparativa Entre Apendicectomia Aberta E Videolaparoscópica No Rio De Janeiro Nos Últimos 5 Anos

“…Este tipo de abdome agudo inflamatório é a maior indicação de retirada do apêndice (apendicectomia), uma vez que até mesmo tumores apendiculares, que são extremamente raros, se apresentam com um quadro de apendicite aguda e acabam sendo diagnosticados pelo exame histopatológico da peça cirúrgica 7,8,9,10 . Os sinais e sintomas clássicos desta doença podem ser definidos como dor abdominal com início em hipogástrio que migra para fossa ilíaca direita, anorexia, febre, leucocitose e outros sinais laboratoriais de inflamação e podem estar presente em mais de 60% dos casos 3 .…”