C. M. Forleiter1, J. A. Schwartz1, D. Y. Lee1, G. J. Kim1 1Mount Sinai School Of Medicine,Mount Sinai Roosevelt Hospital / Department Of Surgery,New York, NY, USA
Introduction: The incidence of appendiceal neoplasms may have been underreported in the past. Patients undergoing incidental appendectomies or appendectomies for chronic appendicitis may be at a higher risk for an occult appendiceal neoplasm.
Methods: Retrospective review of a pathology specimen database spanning four years at a tertiary care hospital center.
Results: A total of 1,793 appendectomy specimens were evaluated. There were 31 (1.7%) appendiceal neoplasms. Fourteen neoplasms were discovered in 1,337 (1.0%) cases of acute appendicitis compared to 2 in 41 (4.9%) cases of chronic and 15 in 415 (3.6%) cases of incidental appendectomies (p < 0.001). Patients with carcinoid tumors were significantly younger compared to others (p = 0.0001). On multivariate analysis, indication for operation was the only significant factor for predicting a tumor.
Conclusion: Patients undergoing interval or incidental appendectomies may be at a higher risk for appendiceal neoplasm compared to other indications. Younger patients may be at a higher risk of occult appendiceal carcinoid neoplasms than other age groups. Pathologic diagnosis in specific high-risk patient groups may be the only way to effectively capture these tumors for optimal treatment.
