Med J Bakirkoy. 2020; 16(2): 160-164 | DOI: 10.5222/BMJ.2020.18189

Incidental Appendiceal Mucinous Neoplasms in Right Hemicolectomy Patients

Salih Tosun¹, Oktay Yener¹, Özgür Ekinci¹, Ihsan Metin Leblebici¹, Ahmet Yusuf Serdaroðlu¹, Mehmet Acar¹, Tuçe Söylemez², Orhan Alimoglu^1
1Istanbul Medeniyet University, School Of Medicine, Department Of General Surgery
²Istanbul Medeniyet University, School Of Medicine, Department Of Pathology

Objective: Subclinical appendiceal mucinous neoplasms (AMN) may accompany to abdominal malignity and this must be considered during colectomies. We aimed to evaluate the treatment and follow-up approach to the patients who have incidentally detected appendix mucinous pathology following right hemicolectomy for abdominal malignancies

Methods: The records of the patients who underwent right hemicolectomy due to benign or malign conditions in our general surgery clinic between January 2016 and December 2019 were analyzed. After the exclusion of hemicolectomies due to benign causes and appendix pathologies detected before the operation, remaining patients’ records were evaluated. The patient records who underwent right hemicolectomy for gastrointestinal or gynecologic malignity were analyzed. The pathologic records of AMNs were included in the study. The incidence of AMN was analyzed and compared with the literature.

Results: 167 of the 214 patients with gastrointestinal or gynecologic malignities were included in this study. 80 patients were female and 87 were male. The mean age was 63 (23-95) years. The incidence of AMN was 2.9% in patients who underwent right hemicolectomy for malignity in three years period. According to the pathological reports; 3 patients (60%) had appendix mucinous neoplasia, one patient (20%) had appendix mucinous cystadenocarcinoma and one (20%) had appendix carcinoid tumor.

Conclusions: Incidentally detected AMN is a rare entity and should be considered during the right hemicolectomy operations of different malignancies. Resections must follow malignancy surgery principles. The preoperative evaluation of the patients needs attention, their postoperative treatment must be planned according to the pathology reports and the patients must be followed for any potential accompanying colorectal tumors.

Keywords: appendectomy, incidental, tumor, appendiceal neoplasm

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Sað Hemikolektomi Hastalarýnda Ýnsidental Olarak Saptanan Appendiks Müsinöz Neoplazmlarý

Salih Tosun¹, Oktay Yener¹, Özgür Ekinci¹, Ihsan Metin Leblebici¹, Ahmet Yusuf Serdaroðlu¹, Mehmet Acar¹, Tuçe Söylemez², Orhan Alimoglu^1
1Istanbul Medeniyet Üniversitesi, Týp Fakültesi, Genel Cerrahi AbD
²Istanbul Medeniyet Üniversitesi, Týp Fakültesi, Patoloji AbD

Amaç: Subklinik apendiks müsinöz neoplazmlarý (AMN) abdominal malignitelere eþlik edebilir ve kolektomiler sýrasýnda göz önünde bulundurulmalýdýr. Çalýþmamýzda, abdominal maligniteler sebebiyle sað hemikolektomi uygulanan hastalarda insidental apendiks müsinöz patoloji saptanmasý halinde tedavi ve takip yaklaþýmýný deðerlendirmeyi amaçladýk.

Metod: Ocak 2016 - Aralýk 2019 yýllarý arasýnda genel cerrahi kliniðimizde benign ya da malign nedenler sebebiyle sað hemikolektomi uygulanan hastalarýn kayýtlarý incelendi. Benign nedenlere baðlý yapýlan hemikolektomiler ve operasyon öncesi appendiks patolojisi saptanan hastalar çalýþma dýþýna alýndýktan sonra kalan olgular incelendi. Gastrointestinal veya jinekolojik malignite için sað hemikolektomi uygulanan hasta dosyalarý deðerlendirildi. Patoloji sonucu AMN olarak raporlananlar çalýþmaya alýndý. Ýnsidental olarak saptanan AMN’ ler deðerlendirilerek literatürle karþýlaþtýrýldý.

Bulgular: 214 hastanýn gastrointestinal veya jinekolojik kaynakli malignite sebebi ile sað hemikolektomi uygulanan 167’ si calýþmaya alýndý. Hastalarýn 80’ i kadýn, 87’ si erkek idi. Yaþ ortalamasý 63 (23-95) idi. Kliniðimizde üç yýllýk sürede malignite sebebiyle sað hemikolektomi operasyonu geçiren hastalarda AMN insidansý %2.9 idi. Patoloji raporlanmasinda 3 hastada (%60) musinoz neoplazi, 1 hastada (%20) musinoz kistadeno kanser saptandý. 1 hastada ise (%20) appendiks karsinoid tümörüyle karþýlaþýldý.

Sonuç: AMN nadir görülen bir antitedir ve malignite nedenli sað hemikolektomilerde akýlda olmalýdýr.Yapýlacak rezeksiyonlar malignite cerrahisi prensipleri gözetilerek gerçekleþtirilmelidir. Hastalarýn preoparatif deðerlendirmeleri dikkatle yapýlmalý, tedavileri postoperatif patoloji sonuçlarýna göre yönlendirilmeli ve hastalar geliþebilecek kolorektal tümörler açýsýndan takip edilmelidir.

Anahtar Kelimeler: appendektomi, insidental, tümör, appendiks neoplazmý

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