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Malignant tumors of the appendix: A retrospective study
Background
Malignant tumors of the appendix are a rare group of tumors often found fortuitously during surgical removal of the appendix, representing approximately 2% of appendectomy specimens. Our objective was to describe the clinico-pathological characteristics of appendicular tumors, the therapeutic modalities proposed and patient’s evolution after treatment.
Methods
We conducted a retrospective review of 52 patients diagnosed with malignant tumors in the Medical Oncology department at Mohamed VI University Hospital, Marrakech, Morocco between 2012 and 2021. The clinical, biological, radiological, therapeutic and evolution data were collected.
Results
The median age was 50 years. The sex ratio was 0.7. Right lower quadrant pain was a constant complaint, followed by constipation, abdominal bloating and/or distension and vomiting. The diagnostic was based on ultrasound and/or abdominal scan. A complementary colonoscopy was proposed for 4 patients. An appendicectomy for performed on all patients after suspecting an acute appendicitis, an appendicular mucocele or for a diagnostic exploration. 42% (22 cases) were found to have a low-grade appendicular mucinous tumor, 34% a mucinous adenocarcinoma (including 5 patients with pseudomyxoma peritonei) and 24% (12 cases) an neuroendocrine tumor. 36% had localized only in the appendix while 64% were already metastatic. The therapeutic management was based on an additional surgical revision by right hemi-colectomy with ileocecal resection and lymph node dissection in 32% (17 cases), while 3% (2 cases) had undergone cytoreductive surgery with intravenous chemotherapy-peritoneal. Adjuvant chemotherapy was indicated to patients with a localized tumor with R0 and positive lymph node dissection which is the case in 7 patients. Palliative chemotherapy was proposed for metastatic patients with an unresectable tumor 26% (14 cases). 55% were under medical surveillance and screening, and 24% of patients relapsed. 21% (11 cases) were lost to follow-up.
Conclusions
Appendicular malignant tumors represent a wide histological spectrum with various clinical subtypes, early diagnosis conditioning its management. Multidisciplinary molecular tumor boards are recommended.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosures
All authors have declared no conflicts of interest.
