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Management of appendiceal neuroendocrine tumors in the light of new guidelines

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Abstract

Purpose

Appendiceal neuroendocrine tumors (ANETs) are the most common in the appendix, detected in histopathological appendectomy specimens, which are resected for acute appendicitis. If tumor detection does not show signs of metastatic disease or obvious features of carcinoid syndrome, preoperative diagnosis remains a challenge. However, the treatment and follow-up algorithm change over time. In our study, we aimed to present 10 years of diagnostic and management experience.

Material and methods

A retrospective study of all patients who underwent emergency appendectomy, with the intention to treat clinically acute appendicitis at Bakirkoy Dr. Sadi Konuk Hospital (Istanbul, Turkey), was undertaken. Patients with diagnoses other than ANETs were excluded. Age, gender, preoperative clinical findings, operative procedure, and histopathological results identified as ANETs were evaluated.

Results

ANETs were detected in 24 patients (0.42%) in the histopathological examination of 5720 appendectomy specimens between December 2011 and October 2020. Mean age of patients was 30 years, with 58.3% female. The majority were located at the tip of appendix (62.5%). Eleven patients (45.83%) were graded as T1, one patient (4.16%) as T2, 11 (41.83%) as T3, and one patient (4.16%) as T4. Secondary hemicolectomy was performed in four patients. Median postoperative follow-up was 43 (17–108) months.

Conclusion

In addition, ANETs are rare and largely detected by chance; therefore, precise examination of routine appendectomy specimens is essential for diagnosis. Accurate tumor staging, in light of new algorithms, has an important place in follow-up and treatment management.

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References

  1. Connor SJ, Hanna GB, Frizelle FA (1998) Appendiceal tumors: retrospective clinicopathologic analysis of appendiceal tumors from 7,970 appendectomies. Dis Colon Rectum 41:75–80

    Article  CAS  Google Scholar 

  2. Marmor S, Portschy PR, Tuttle TM et al (2015) The rise in appendiceal cancer incidence: 2000–2009. J Gastrointest Surg 19:743–750

    Article  Google Scholar 

  3. Murray SE, Lloyd RV, Sippel RS et al (2014) Postoperative surveillance of small appendiceal carcinoid tumors. Am J Surg 207:342–345

    Article  Google Scholar 

  4. Moris D, Tsilimigras DI, Vagios S et al (2018) Neuroendocrine neoplasms of the appendix: a review of the literature. Anticancer Res 38:601–611

    PubMed  Google Scholar 

  5. Ellis L, Shale MJ, Coleman MP (2010) Carcinoid tumors of the gastrointestinal tract: trends in incidence in England since 1971. Am J Gastroenterol 105:2563–2569

    Article  Google Scholar 

  6. Zhang X, Ma L, Bao H et al (2014) Clinical, pathological and prognostic characteristics of gastroenteropancreatic neuroendocrine neoplasms in China: a retrospective study. BMC Endocr Disord 14:54–56

    Article  Google Scholar 

  7. Henderson L, Fehily C, Folaranmi S et al (2014) Management and outcome of neuroendocrine tumours of the appendix: a two-centre UK experience. J Pediatr Surg 49:1513–1517

    Article  Google Scholar 

  8. Abdelaal A, El Ansari W, Al-Bozom I et al (2017) Frequency, characteristics, and outcomes of appendicular neuroendocrine tumors: a cross-sectional study from an academic tertiary care hospital. Ann Med Surg (Lond) 21:20–24

    Article  Google Scholar 

  9. Emre A, Akbulut S, Bozdag Z et al (2013) Routine histopathologic examination of appendectomy specimens: retrospective analysis of 1,255 patients. Int Surg 98:354–362

    Article  Google Scholar 

  10. Coursey CA, Nelson RC, Moreno RD et al (2010) Carcinoid tumors of the appendix: are these tumors identifiable prospectively on preoperative CT? Am Surg 76:273–275

    Article  Google Scholar 

  11. Kangaspunta H, Tahkola K, Wirta EV et al (2020) Preoperative computed tomography is poor in detecting tumors of the appendix among patients with acute appendicitis: a cohort study of 5,224 appendectomies. J Trauma Acute Care Surg 88:396–401

    Article  Google Scholar 

  12. Davenport E, Courtney ED, Benson-Cooper S, Bissett IP (2014) Appendiceal neuroendocrine neoplasms in the era of laparoscopic appendectomy. Anz J Surg 84:337–340

    Article  Google Scholar 

  13. Pawa N, Clift AK, Osmani H et al (2018) Surgical management of patients with neuroendocrine neoplasms of the appendix: appendectomy or more. Neuroendocrinology 106:242–251

    Article  CAS  Google Scholar 

  14. Dimitrios M, Diamantis IT, Stylianos V et al (2018) neuroendocrine neoplasms of the appendix: a review of the literature. Anticancer Res 38:601–611

    Google Scholar 

  15. Pape UF, Niederle B, Costa F et al (2016) Vienna consensus conference: ENETS consensus guidelines for neuroendocrine neoplasms of the appendix (excluding goblet cell carcinomas). Neuroendocrinology 103:144–152

    Article  CAS  Google Scholar 

  16. Kulke MH, Shah MH, Benson AB et al (2015) Neuroendocrine tumors, version 1.2015. J Natl Compr Canc Netw 13:78–108

    Article  CAS  Google Scholar 

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Correspondence to Turgut Donmez.

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Bakirkoy Dr. Sadi Konuk Education and Research Hospital. (20.07.2020/2020–15).

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Gumuşoglu, A.Y., Donmez, T., Kabuli, H.A. et al. Management of appendiceal neuroendocrine tumors in the light of new guidelines. Ir J Med Sci 191, 1133–1137 (2022). https://doi.org/10.1007/s11845-021-02707-y

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  • DOI: https://doi.org/10.1007/s11845-021-02707-y

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