R. F. Brown1, K. Cools1, M. Shah1, W. Stepp1, T. Reid1, A. Charles1 1University Of North Carolina At Chapel Hill,Chapel Hill, NC, USA
Introduction: Patients with a primary appendiceal neoplasm (PAN) often present with variable symptoms, including those of acute appendicitis (AA). However, with the incidence of PAN increasing nearly two-fold over the past ten years, it is vital to evaluate the effect this has on patients who present with AA, but ultimately have PAN. The purpose of this study is to identify variations in PAN incidentally diagnosed after treatment for AA.
Methods: A retrospective review of a pathology database was performed identifying all patients who underwent surgical management of AA between January 2000 and December 2015. Pathology reports were reviewed and patients with PAN were identified. Pearson chi-squared test was performed to compare the difference in incidence of PAN after treatment for AA.
Results: Of the 4336 patients surgically treated for AA between 2000-2015, 1.2% (n=51) had PAM. Between 2000-2005, incidence of PAN in those presenting with AA was 0.5% compared to 1.3% between 2006-2010 and 1.6% between 2011-2015 (p<0.001 for all). Table 1 demonstrates patient demographic and histopathological variation over these time periods. This indicates an increase in the proportion of carcinoid, adenocarcinomas, mixed adenoneuroendocrine carcinomas, and other malignant tumors over time.
Conclusions: Our data suggest that the incidence of PAN presenting as AA is significantly increasing over time. Additionally, there appears to be a shift in the pathologic variation of PAM, with a decrease in mucinous cystadenomas and an increase in adenocarcinoma and mixed adenoneuroendocrine carcinomas. These findings suggest that acute care surgeons must be increasingly aware that every appendectomy is potentially an oncologic procedure.
