Dohner, Eliane; Kierdorf, Fiona Joséphine; Langer, Rupert; Zuber, Markus; Fahrner, René (2024). Retrospective analysis of the incidence of appendiceal neoplasm and malignancy in patients treated for suspected acute appendicitis. BMC surgery, 24(121) BioMed Central 10.1186/s12893-024-02412-4
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BACKGROUND
Nonoperative management of uncomplicated appendicitis is currently being promoted as treatment option, albeit 0.7-2.5% of appendectomies performed due to suspected acute appendicitis show histologically malignant findings. The purpose of this study was to investigate the incidence of neoplasm and malignancy of the appendix in patients presenting with suspected acute appendicitis in real world setting.
METHODS
This is a retrospective single-centre investigation of 457 patients undergoing appendectomy between the years 2017-2020. The patients' demographics, symptoms and diagnosis, intraoperative findings, and histopathological results were analysed.
RESULTS
In 3.7% (n = 17) histological analysis revealed neoplasms or malignancies. Median age was 48 years (20-90 years), without sex predominance. Leukocytes (11.3 ± 3.7 G/l) and C-reactive protein (54.2 ± 69.0 mg/l) were elevated. Histological analysis revealed low-grade mucinous appendiceal neoplasia (n = 3), sessile serrated adenoma of the appendix (n = 3), neuroendocrine tumours (n = 7), appendiceal adenocarcinoma of intestinal type (n = 3), and goblet cell carcinoma (n = 1). Additional treatment varied between no treatment or follow-up due to early tumour stage (n = 4), follow-up care (n = 3), additional surgical treatment (n = 8), or best supportive care (n = 2).
CONCLUSIONS
Preoperative diagnosis of appendiceal tumours is difficult. Nonoperative management of patients with acute, uncomplicated appendicitis potentially prevents the correct diagnosis of malignant appendiceal pathologies. Therefore, close follow-up or surgical removal of the appendix is mandatory.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Vascular Surgery 04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine |
UniBE Contributor: |
Dohner, Eliane, Fahrner, René |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1471-2482 |
Publisher: |
BioMed Central |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
25 Apr 2024 10:42 |
Last Modified: |
25 Apr 2024 10:51 |
Publisher DOI: |
10.1186/s12893-024-02412-4 |
PubMed ID: |
38658891 |
Uncontrolled Keywords: |
Acute appendicitis Appendectomy Appendiceal malignancy Appendiceal neoplasm Retrospective study |
BORIS DOI: |
10.48350/196219 |
URI: |
https://boris.unibe.ch/id/eprint/196219 |
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