Neuroendocrine Neoplasm in Cecal Appendix: A Case Report

Abstract

Although neuroendocrine neoplasms are relatively uncommon entities, the appendix is a site with relatively frequent emergence of this pathology and its precise diagnosis and clinical management have been a challenge for practitioners. This paper aims to present and discuss a case report of neuroendocrine neoplasia in the appendix of a patient with acute abdomen who underwent appendectomy. A 46-year-old man referred to the Emergency Department complaining of abdominal pain in the right iliac fossa and signs of peritoneal irritation. After diagnosis of acute appendicitis, the patient underwent appendectomy. In a macroscopic analysis, an area of 1.9 cm long, hardened, irregular and yellowish shapes was noted in the distal third of the appendix. Histopathological analysis showed neoplasia consisting of invasive islands of monotonous rounded epithelioid cells, large areas of necrosis, high mitotic activity, neural and angiolymphatic invasion and extension to adipose tissue compatible with invasion of the mesoappendix. Circumferential resection was compromised, suggesting the persistence of neoplasia in the patient even after the surgical approach, which would probably recommend the need for surgical approach. Therefore, the importance of sending collected materials for anatomopathological analysis is emphasized, since it helps in the clinical evaluation, in the etiological diagnosis, guides the medical conduct in the evolution of the case, as well as assisting in family mourning in cases of mortality.Keywords: Neuroendocrine tumor, Appendix, Histopathological analysis.