Incidental neuroendocrine tumors of appendix: study from a tertiary care hospital

Our aim is to study the data of patients who underwent appendectomy for clinically diagnosed acute appendicitis, and the neuroendocrine tumor was detected as an incidental finding. A retrospective Data of 1728 patients who underwent appendectomy for clinical diagnosis of appendicitis over a period of four years was evaluated in the department of pathology. The records of patients, who were reported as neuroendocrine tumors on histopathology, from those 1728 patients, were examined in detail in terms of demographic data, size of tumor, histopathological diagnosis and grading, status of margins, depth of invasion, lymphovascular emboli, perineural invasion, and immunohistochemical features. All the cases of neuroendocrine tumors were followed up for any recurrence or revised treatment. Neuroendocrine tumors were detected incidentally in 8 (0.46%) out of 1728 appendectomy specimens. There was a male predominance, with 6 (75%) cases being males and 2 (25%) females. The clinical presentation in all cases was resembled acute appendicitis. The mean age was 18.25 (range: 3-31). The mean size was 8.75 mm (range: 6 mm-1 cm). Revised hemicolectomy was done in two patients. In both the reoperated cases, no residual tumor was detected. Neuroendocrine tumors of the appendix usually present as acute appendicitis and are detected incidentally on appendectomy specimens operated for acute appendicitis. Hence, careful and meticulous histopathological examination of all appendectomy specimens is mandatory to detect a hidden neuroendocrine tumor and to detect various adverse histopathological findings which will determine further treatment. (author)