Can Appendiceal Neoplasms Be Predicted in Patients with Presumed Acute Appendicitis?

Şevki Pedük

doi:10.58600/eurjther1977

Authors

Şevki Pedük Department of Surgical Oncology, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul, Türkiye https://orcid.org/0000-0002-7476-384X

DOI:

https://doi.org/10.58600/eurjther1977

Keywords:

Appendicitis, Appendectomy, Appendiceal Neoplasms, Appendiceal Tumor

Abstract

Objective: The detection of malignancy in the final pathology report of patients undergoing surgery for acute appendicitis is a nasty surprise for both the patient and the clinician. To improve the management of this situation, we analyzed clues for predicting possible neoplasms.

Methods: We analyzed in detail the data of patients operated on in our department with a preliminary diagnosis of acute appendicitis over 42 months. The group whose final pathology was reported as primary appendiceal neoplasm was compared with the acute appendicitis group.

Results: Appendiceal neoplasm was detected in 16 patients (1%). Half of these were mucinous epithelial neoplasms. Neuroendocrine tumors (18.7%) were the second most common neoplasm. According to the logistic regression model, low hemoglobin level (p<0.01) and low Alvarado score (p:0.02) were the two most valuable factors in the prediction of primary appendiceal neoplasms. Laboratory findings of high neutrophil/lymphocyte ratio (p<0.01) and plastron formation on imaging (p:0.03) were more common in the neoplasm group. Advanced age, comorbidity, immunosuppression and inflammatory bowel diseases (IBD) were other characteristics of the neoplasm group.

Conclusions: Appendiceal neoplasms should always be considered in anemic patients with relatively low Alvarado scores.

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