Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Clinical Characteristics, Surgical Management, and Outcomes of Appendiceal Neoplasms: Retrospective Study of 35 Cases
Apendiks Neoplazmlarının Klinik Özellikleri, Cerrahi Yönetimi ve Sonuçları: 35 Olgunun Retrospektif İncelemesi
Mehmet TORUNa , Erkan ÖZKANb , Meryem Günay GÜRLEYİKb , Fügen VARDAR AKERc , Aylin GÖNÜLTAŞc
aErzurum State Hospital, Clinic of Gastrointestinal Surgery, Erzurum, Türkiye
bUniversity of Health Sciences Haydarpaşa Numune Training and Research Hospital, Clinic of General Surgery, İstanbul, Türkiye
cUniversity of Health Sciences Haydarpaşa Numune Training and Research Hospital, Clinic of Pathology, İstanbul, Türkiye
Turkiye Klinikleri J Med Sci. 2025;45(3):141-7
doi: 10.5336/medsci.2024-107563
Article Language: EN
Full Text
ABSTRACT
 Objective: Appendiceal neoplasms are rare, present diagnostic challenges due to nonspecific symptoms resembling acute appendicitis. This study aims to evaluate the clinical characteristics, diagnostic accuracy, surgical management, long-term outcomes of patients with appendiceal neoplasms who underwent appendectomy. Material and Methods: A retrospective analysis was conducted on 35 patients diagnosed with appendiceal neoplasms from a cohort of 3,361 appendectomy cases at the Haydarpaşa Numune Training and Research Hospital between 2013-2023. Data on demographics, preoperative imaging, intraoperative findings, histopathological results, surgical interventions, and follow-up outcomes were analyzed. Results: Of the 35 patients, 19 (54.3%) were female, and 16 (45.7%) were male, with a mean age of 42.7 years. The most common diagnosis was appendix neuroendocrine tumor (57.1%), followed by mucinous neoplasms and colonic-type adenocarcinomas. None of the neoplastic cases were diagnosed preoperatively. Laparoscopic appendectomy was performed in 14.3% of cases, with the remaining patients undergoing open surgery. Right hemicolectomy was required in 7 (20%) cases. Postoperative colonoscopy was performed for all patients, with adenocarcinoma cases enrolled in colorectal cancer follow-up programs. During the follow-up period, 2 (5.7%) patients died of advanced disease, while the remaining patients showed good long-term survival, with a mean follow-up of 59 months. Conclusion: Although appendiceal neoplasms are rare, they present significant diagnostic and management challenges. Early detection is difficult, but appropriate surgical management and rigorous follow-up, particularly for adenocarcinoma cases, are crucial for improving outcomes. Advancements in imaging and molecular diagnostics may improve preoperative detection in the future.

Keywords: Appendiceal neoplasms; neuroendocrine tumor; mucinous neoplasms; adenocarcinoma; appendectomy
ÖZET
 Amaç: Apendiks neoplazmları, nadir görülür ve akut apandisite benzeyen özgün olmayan semptomları nedeniyle tanısal zorluklar oluşturur. Bu çalışma, apendektomi uygulanan apendiks neoplazmı hastalarının klinik özelliklerini, tanısal doğruluğunu, cerrahi yönetimini ve uzun dönem sonuçlarını değerlendirmeyi amaçlamaktadır. Gereç ve Yöntemler: Haydarpaşa Numune Eğitim ve Araştırma Hastanesinde, 2013-2023 yılları arasında gerçekleştirilen 3.361 apendektomi olgusu arasından apendiks neoplazmı tanısı alan 35 hasta retrospektif olarak incelendi. Hastaların demografik verileri, preoperatif görüntüleme yöntemleri, intraoperatif bulguları, histopatolojik sonuçları, cerrahi girişimleri ve takip sonuçları analiz edildi. Bulgular: Otuz beş hastanın 19'u (%54,3) kadın, 16'sı (%45,7) erkek olup; yaş ortalaması 42,7 idi. En sık görülen histopatolojik tanı apendiks nöroendokrin tümörü (%57,1) olup, bunu müsinöz neoplazmlar ve kolon tipi adenokarsinomlar izledi. Preoperatif dönemde, hiçbir olgu doğru şekilde neoplastik apandisit tanısı almadı. Hastaların %14,3'üne laparoskopik apendektomi, geri kalanına ise açık cerrahi uygulandı. Yedi (%20) hastada sağ hemikolektomi gerekli görüldü. Tüm hastalara postoperatif kolonoskopi uygulandı ve adenokarsinom olguları, kolorektal kanser takip programına dâhil edildi. Takip sürecinde 2 (%5,7) hasta ileri hastalık nedeniyle yaşamını yitirirken, diğer hastalarda ortalama 59 aylık takip süresi boyunca iyi uzun dönem sağkalım gözlendi. Sonuç: Apendiks neoplazmları, nadir görülmekle birlikte tanı ve tedavi açısından önemli zorluklar sunar. Erken tanı genellikle zordur, ancak uygun cerrahi müdahale ve özellikle adenokarsinom olgularında titiz takip, hasta sonuçlarını iyileştirmede kritik öneme sahiptir. Görüntüleme ve moleküler tanı yöntemlerindeki ilerlemeler, gelecekte preoperatif tanıyı iyileştirebilir.

Anahtar Kelimeler: Apendiks neoplazmları; nöroendokrin tümör; müsinöz neoplazmlar; adenokarsinom; apendektomi
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