Local Protocol for Management of Low-Grade Appendiceal Mucinous Neoplasm (LAMN)

Boshnaq, Mohamed; Toeima, Mohamed; Hamade, Ayman; Bagla, Nipin

doi:10.1007/s13193-020-01147-x

Cited by 13 publications

(7 citation statements)

References 21 publications

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“…[11][12][13] A typical feature of LAMN is their pattern of invasion of the layers of the appendix, otherwise known as "pushing invasion", which increases the possibility of ovarian involvement. 14 There is evidence that these lesions are often associated with a high frequency of KRAS mutations and risk of peritoneal dissemination. 15 An LAMN in an appendix without rupture or perforation is adequately treated with appendectomy with removal of the entire mesoappendix, with very low recurrence rates.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative predictors of appendiceal abnormalities in patients with mucinous ovarian neoplasms

Lavecchia

Dubey

Jiménez

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo evaluate intraoperative factors predicting appendiceal pathology during gynecologic oncology surgery for suspected mucinous ovarian neoplasms.MethodsWe conducted a retrospective study on 225 patients with mucinous ovarian neoplasms who underwent surgery for an adnexal mass with concurrent appendectomy between 2000 and 2018. Regression analyses were used to evaluate intraoperative factors, such as frozen section of the ovarian mass and surgeon's impression of the appendix in predicting appendiceal pathology.ResultsMost patients (77.8%) had a normal appendix on final pathology. Abnormal appendix cases (n = 26) included: metastasis from high‐grade adenocarcinoma of the ovary (n = 1), neuroendocrine tumor of the appendix (n = 4), and low‐grade appendiceal mucinous neoplasms (n = 26; 23 associated with a mucinous ovarian adenocarcinoma, 2 with a benign mucinous ovarian cystadenoma, and 1 with a borderline mucinous ovarian tumor). Combining normal intraoperative appearance of the appendix with benign or borderline frozen section yielded a negative predictive value of 85.1%, with 14.9% of patients being misclassified, and 6.0% having a neuroendocrine tumor or low‐grade appendiceal neoplasm.ConclusionBenign or borderline frozen section of an ovarian mucinous neoplasm and normal appearing appendix have limited predictive value for appendiceal pathology. Appendectomy with removal of the mesoappendix should be considered in all cases of mucinous ovarian neoplasm, regardless of intraoperative findings.

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Section: Discussionmentioning

confidence: 99%

Intraoperative predictors of appendiceal abnormalities in patients with mucinous ovarian neoplasms

Lavecchia

Dubey

Jiménez

et al. 2023

Intl J Gynecology & Obste

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“…Einzelne Fälle wurden als Zufallsbefunde in der CT erkannt bzw. suszipiert [11]. In einigen Fällen konnte eine LAMN im Rahmen einer diagnostischen Laparoskopie festgestellt werden [4].…”

Section: Diskussionunclassified

Großer zystischer Abdominaltumor bedingt durch eine niedrig maligne Neoplasie der Appendix

Trifina-Mikosch¹,

Barta²,

Krampla³

et al. 2023

Geburtshilfe Frauenheilkd

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Tumoröse Veränderungen im Beckenbereich haben vielfältige Ursachen. Eine Einschätzung ist oft schwierig, und Fälle mit Fehlzuordnungen, die erst durch eine histopathologische Aufarbeitung geklärt werden konnten, sind in der Literatur beschrieben 1 2 3 . Bei tumorösen Veränderungen der Adnexe ist primär an einen Tumor der Adnexe bzw. Metastasen anderer abdomineller Organe – Uterus, Harnblase, Darm – zu denken.

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“…3,4 Treatment entails surgical resection by appendectomy or colectomy, and pathologic testing confirms the diagnosis and T-category of the lesion. [5][6][7] Although surgical resection of LAMNs is generally curative, 8,9 many physicians routinely recommend surveillance to these patients due to concerns about disease recurrence and development of pseudomyxoma peritonei, a feared complication of mucinous neoplasms characterized by abundant deposition of mucus across the peritoneal cavity. 2,10 Several studies have assessed recurrence rates of LAMN and have suggested that this risk is negligible.…”

Section: Introductionmentioning

confidence: 99%

Necessity of posttreatment surveillance for low‐grade appendiceal mucinous neoplasms

Gupta

Brajcich

Yang

et al. 2021

Journal of Surgical Oncology

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Background and Objectives: Low-grade appendiceal mucinous neoplasms (LAMNs) are generally treated by surgical resection, but posttreatment surveillance protocols are not well-established. The objectives of this study were to characterize posttreatment surveillance and determine the risk of recurrence following surgical resection of LAMN.Methods: Patients who underwent surgical resection of localized LAMNs in an 11-hospital regional healthcare system from 2000 to 2019 were identified. Posttreatment surveillance regimens were characterized, and rates of disease recurrence were evaluated.Results: A total of 114 patients with LAMNs were identified. T-category was pTis for 92 patients (80.7%), pT3 for 7 (6.1%), pT4a for 14 (12.3%), and pT4b for 1 (0.9%).Two patients (1.8%) had a positive resection margin. Posttreatment surveillance was performed for 39 (34.2%) patients and consisted of office visits for 32 (82%) patients, computerized tomography imaging for 30 (77%), magnetic resonance imaging for 5 (13%), colonoscopy for 15 (38%), and serum tumor marker measurement for 12 (31%). After a mean follow-up duration of 4.7 years, no patients experienced tumor recurrence.Conclusions: Posttreatment surveillance is common among patients with LAMNs.However, no patients experienced tumor recurrence, regardless of T-category or margin status, suggesting that routine surveillance following surgical resection of LAMN may be unnecessary.

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Local Protocol for Management of Low-Grade Appendiceal Mucinous Neoplasm (LAMN)

Cited by 13 publications

References 21 publications

Intraoperative predictors of appendiceal abnormalities in patients with mucinous ovarian neoplasms

Intraoperative predictors of appendiceal abnormalities in patients with mucinous ovarian neoplasms

Großer zystischer Abdominaltumor bedingt durch eine niedrig maligne Neoplasie der Appendix

Necessity of posttreatment surveillance for low‐grade appendiceal mucinous neoplasms

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