TP9.2.22A six year retrospective study of appendicular neoplasms and review of literature

Aims The aim of this study was to evaluate the incidence of appendiceal neoplasm, identify possible association of pre and intra-operative factors associated with it, and to determine its clinical significance. Methods Using pathological reports from surgical specimens of appendix from January 2015 to September 2020, a single centre retrospective analysis was performed. Medical records of patients, pre-operative investigations, intra operative findings, histological reports and post operative management were evaluated. Results The incidence of appendiceal neoplasms was 2.33% (65/2791). They consisted of Neuroendocrine tumor (NET) in 35(53.85%), followed by Low grade mucinous neoplasm (LAMN) in 23(35.38%), Goblet cell carcinoid in three (4.62%), mucinous cystadenoma 2(3.08%), one (1.54%) adenocarcinoma and one (1.54%) metastasis. Appendicitis was the most common indication for surgery. 46(70.77%) patients had emergency surgery. 89.13% emergency surgeries was appendicectomy, NET being the most common tumor in 60.87%. 19(29.23%) patients had elective surgery, all had pre operative radiological investigation, LAMN being most common. Only five (7.69%) patients had intra operative suspicion of tumor. Ten patients required second procedure in the form of right hemicolectomy in nine, and cytoreducetive surgery in one. All patients were followed up as per national guidelines. Conclusions The incidence of appendiceal neoplasms though low, has been steadily rising. Its diagnosis is rarely evident on pre operative radiological investigations. Surgeons should be aware of these neoplasms and its frequent association with emergency appendicectomies done for suspected acute appendicitis.