Neuroendocrine Neoplasms of the Appendix: A Review of the Literature

Moris, Demetrios; Tsilimigras, Diamantis I.; Vagios, Stylianos; Ntanasis‐Stathopoulos, Ioannis; Karachaliou, Georgia‐Sofia; Papalampros, Alexandros; Alexandrou, Andreas; Blazer, Dan G.; Felekouras, Evangelos

doi:10.21873/anticanres.12264

Cited by 57 publications

(66 citation statements)

References 56 publications

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“…In these tumors, right hemicolectomy should be performed. [11] Because of the long-term risk of recurrence, right hemicolectomy should also be considered in carcinoids 1-2 cm in size, if the following factors are present: involvement of the mesoappendix, demonstrable angioinvasion, apparent high proliferative index and Ki67 level, tumor located at the base of the appendix with positive margins, and in younger patients with positive lymph nodes. If tumor size <1 cm, appendectomy is enough for a cure.…”

Section: Discussionmentioning

confidence: 99%

Carcinoid Tumors of Appendix Presenting as Acute Appendicitis

Barut

Gönültaş

2018

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: We aim to present the data of patients who underwent appendectomy due to acute appendicitis, and incidental carcinoid tumor was detected on pathology. METHODS: Retrospective analysis of the patient charts between January 1999 and September 2018 were performed. RESULTS: 2778 appendectomy was performed due to acute appendicitis. Appendiceal carcinoid tumor was detected in 12 (0.43%) patients. Eight patients were (66.7%) female. Median age 37.5 years (range: 21-60). The median tumor size was 0.7 cm (range: 0.1-2.5). No perforation was detected. Eleven patients underwent appendectomy, and one patient had right hemicolectomy. The median followup period was 41.5 months (range: 22-49). There were no recurrences. CONCLUSION: Appendix carcinoid tumors are quite rare, usually asymptomatic and diagnosed incidentally on histopathological examination after appendectomy. The treatment of carcinoid tumors of the appendix is directly related to the tumor size, localization, presence of lymphovascular and mesoappendix invasion, mitotic activation rate and level of Ki67. Thus, it is important to follow the histopathological results after appendectomy. The prognosis of appendix carcinoid tumors is very good if the appendix is non-perforated.

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Section: Discussionmentioning

confidence: 99%

Carcinoid Tumors of Appendix Presenting as Acute Appendicitis

Barut

Gönültaş

2018

Ulus Travma Acil Cerrahi Derg

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“…Among carcinomas of the gastrointestinal tract, appendiceal primaries are rare [43,44]. Moreover, appendiceal signet ring cell carcinoma is an extremely rare malignancy, that accounts for 4% of all appendiceal tumors [45].…”

Section: Discussionmentioning

confidence: 99%

Endometrium-Limited Metastasis of Extragenital Malignancies: A Challenge in the Diagnosis of Endometrial Curettage Specimens

Choi

Joo

et al. 2020

Diagnostics

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Malignancies of extragenital origin very rarely metastasize to the uterine body. Endometrium-limited metastases may pose diagnostic challenges in endometrial curettage specimens as they may be misdiagnosed as primary endometrial tumors. We investigated the clinicopathological characteristics of seven cases with endometrial-limited metastases from carcinomas of the nasopharynx (n = 1), breast (n = 2), colon (n = 2), stomach (n = 1), and appendix (n = 1). The patients’ ages ranged from 36 to 71 (mean: 55.4) years. None of the patients had a remarkable gynecological history, and the presenting sign in all cases was abnormal uterine bleeding. Although myometrial involvement was absent, multiple metastases were already present in extrauterine locations such as the lung, liver, bone, abdominopelvic peritoneum, and omentum. All patients underwent ultrasonographic examination prior to endometrial curettage. The histologies of the endometrial metastases identified from the curettage specimens were identical to those of the corresponding primary tumors. Ancillary tests including immunostaining and Epstein–Barr virus-encoded RNA in situ hybridization confirmed the extragenital origin. Endometrium-limited metastases from extragenital malignancies are extremely rare. They present with abnormal vaginal bleeding and mimic endometrial carcinomas of endometrioid or poorly differentiated types. Since their clinical presentations and histological features are similar to those of primary endometrial tumors, pathologists should consider the possibility of metastases while evaluating endometrial curettage specimens obtained from patients with a history of extragenital malignancies.

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“…In most patients with appendix neuroendocrine neoplasm with a tumor diameter <1 cm, isolated appendectomy is sufficient for treatment, as they rarely metastasize (Gu;Wang;Xu, 2015). Tumors smaller than or equal to 2 cm that infiltrate the submucosa, muscle, subserosa and mesoappendix (at least 3mm deep) are considered to be stage IIa by the TNM classification of ENETS -European Neuroendocrine Tumors Society (Moris et al, 2018) and should be treated with right hemicolectomy, not just appendectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the follow-up of these patients, the literature shows that regular followup is required for tumors between 1 and 2 cm with high risk factors for lymphatic spread of the disease, as well as in cases of mesoappendix invasion of more than 3 mm, localization of the injury at the base of the appendix, vascular infiltration or intermediate differentiation (Moris et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Neuroendocrine Neoplasm in Cecal Appendix: A Case Report

Feitosa

Rodrigues

Felix

et al. 2019

AIMJ

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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.

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Neuroendocrine Neoplasms of the Appendix: A Review of the Literature

Cited by 57 publications

References 56 publications

Carcinoid Tumors of Appendix Presenting as Acute Appendicitis

Carcinoid Tumors of Appendix Presenting as Acute Appendicitis

Endometrium-Limited Metastasis of Extragenital Malignancies: A Challenge in the Diagnosis of Endometrial Curettage Specimens

Neuroendocrine Neoplasm in Cecal Appendix: A Case Report

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