Article Data

  • Views 2272
  • Dowloads 185

Original Research

Open Access

Incidental appendiceal neoplasias: ten years' experience with 1,642 patients

  • Server Sezgin Uludag1
  • Nazim Gures2
  • Abdullah Kagan Zengin1

1Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of General Surgery, İstanbul, Turkey

2Balikesir Atatürk City Hospital, Department of General Surgery, İstanbul, Turkey

DOI: 10.22514/sv.2020.16.0093 Vol.17,Issue 1,January 2021 pp.75-78

Published: 08 January 2021

*Corresponding Author(s): Server Sezgin Uludag E-mail:


Background: Acute appendicitis is the most common surgical emergency. In this study, we investigated the rate of neoplasia among patients who underwent an appendectomy in our center, a large Tertiary Care Teaching Hospital. Methods: We retrospectively reviewed 1,642 cases of appendectomies performed between 2007 and 2017. In this study, the data included demographic data, operative and pathological findings, and additional procedures following the appendectomy. Results: Of the 1,642 appendectomies, 1,294 were laparoscopic, and 348 were open procedures. Appendiceal neoplasia was encountered in the examination of appendix specimens taken from 20 patients. Sessile serrated adenoma (SSRA) was found in seven patients, neuroendocrine tumor (NET) in six patients, low-grade mucinous neoplasia (LGMN) in four patients, mucinous cystadenoma (MCA) in two patients, and diffuse adenoma (DA) in one patient. Two patients underwent right hemicolectomy due to positive surgical margins from previous surgeries. Colonoscopy and computed tomography (CT) control were performed on all neoplasia patients during the postoperative period, and no additional pathology was seen. Conclusions: Although the probability of neoplasia after appendectomy is low, it should be considered. Adenomas and neuroendocrine tumors seem to be the most common neoplasias that are incidentally encountered in appendectomy specimens.


Acute appendicitis; Appendiceal neoplasia; Sessile serrated adenoma; Neuroendocrine tumor

Cite and Share

Server Sezgin Uludag,Nazim Gures,Abdullah Kagan Zengin. Incidental appendiceal neoplasias: ten years' experience with 1,642 patients. SignaVitae. 2021. 17(1);75-78.


[1] Wagner M, Tubre DJ, Asensio JA. Evolution and current trends in the management of acute appendicitis. Surgical Clinics of North America. 2018; 98: 1005-1023.

[2] Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. The Lancet. 2015; 386: 1278-1287.

[3] Becker P, Fichtner-Feigl S, Schilling D. Clinical management of appendicitis. Visceral Medicine. 2018; 34: 453-458.

[4] Sohn M, Agha A, Bremer S, Lehmann KS, Bormann M, Hochrein A. Surgical management of acute appendicitis in adults: a review of current techniques. International Journal of Surgery. 2017; 48: 232-239.

[5] Hatch QM, Gilbert EW. Appendiceal neoplasms. Clinics in Colon and Rectal Surgery. 2018; 31: 278-287.

[6] Coccolini F, Fugazzola P, Sartelli M, Cicuttin E, Sibilla MG, Leandro G, et al. Conservative treatment of acute appendicitis. Acta Biomedica. 2018; 89: 119-134.

[7] Glasgow SC, Gaertner W, Stewart D, Davids J, Alavi K, Paquette IM, et al. The American Society of Colon and Rectal Surgeons, Clinical practice guidelines for the management of appendiceal neoplasms. Diseases of the Colon & Rectum. 2019; 62: 1425-1438.

[8] Eğin S, Kamalı G, Kamalı S, Gökçek B, Yeşiltaş M, Hot S, Karakaş DÖ. Neuroendocrine tumor of the appendix: twelve years of results from a single institution. Ulusal Travma ve Acil Cerrahi Dergisi. 2019; 25: 118-122.

[9] Şenel F, Karaman H, Demir H. Neuroendocrine tumors detected in appendectomy specimens: ten-year single-center experience. Turkish Journal of Medical sciences. 2018; 48: 68-73.

[10] Pape UF, Niederle B, Costa F, Gross D, Kelestimur F, Kianmanesh R, et al. Vienna Consensus Conference participants ENETS consensus guidelines for neuroendocrine neoplasms of the appendix (excluding goblet cell carcinomas). Neuroendocrinology. 2016; 103: 144-152.

[11] Bettington M, Brown IS, Rosty C. Serrated lesions of the appendix in serrated polyposis patients. Pathology. 2016; 48: 30-34.

[12] Yuyucu Karabulut Y, Savaş B, Kurşun N, Ensar A. Serrated lesions of the appendix: do they differ from their colorectal counterparts? Turkish Journal of Gastroenterology. 2014; 25: 29-34.

[13] Renshaw AA, Kish R, Gould EW. Sessile serrated adenoma is associated with acute appendicitis in patients 30 years or older. The American Journal of Clinical Pathology. 2006; 126: 875-877.

[14] Wong M, Barrows B, Gangi A, Kim S, Mertens RB, Dhall D. Low-grade appendiceal mucinous neoplasms: a single institution experience of 64 cases with clinical follow-up and correlation with the current (eighth edition) AJCC staging. International Journal of Surgical Pathology. 2020; 28: 252-258.

[15] Nutu OA, Marcacuzco Quinto AA, Manrique Municio A, Justo Alonso I, Calvo Pulido J, García-Conde M, et al. Mucinous appendiceal neoplasms: incidence, diagnosis and surgical treatment. Cirugía Española. 2017; 95:321-327.

[16] González-Moreno S, Sugarbaker PH. Radical appendectomy as an alternative to right colon resection in patients with epithelial appendiceal neoplasms. Surgical Oncology. 2017; 26: 86-90.

[17] Shiihara M, Ohki T, Yamamoto M. Preoperative diagnosis and surgical approach of appendiceal mucinous cystadenoma: usefulness of volcano sign. Case Reports in Gastroenterology. 2017; 11: 539-544.

[18] Dincel O, Goksu M, Turk BA, Pehlivanoglu B, Isler S. Unexpected findings in the routine histopathological examinations of appendectomy specimens: a retrospective analysis of 1,970 patients. Annali Italiani di Chirurgia. 2017; 88: 519-525.

[19] Agrusa A, Romano G, Galia M, Cucinella G, Sorce V, Di Buono G, et al. Appendiceal mucinous neoplasms: an uncertain nosological entity. Report of a case. Il Giornale di chirurgia. 2016; 37: 86-89.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time