Appendix Cancer Tumours
โ ๏ธ For appendiceal carcinoids, right hemicolectomy is recommended if the tumour is >2 cm, or if smaller but with mesoappendiceal invasion. โ
Most patients have localized disease and the prognosis is excellent.
๐ About
- Appendix cancers are very rare tumours of the vermiform appendix.
๐ฆ Malignant Tumours
- Adenocarcinoma
- Carcinoid (most common primary appendix tumour)
- Lymphoma
- Metastases (e.g., from ovary, colon)
๐ฑ Benign Tumours
- Retention cyst
- Villous hyperplasia
- Cystadenoma
- Cystadenocarcinoma
๐ฉบ Clinical Features
- May present like acute appendicitis
- Abdominal pain, distension, or local invasion
- Can cause ascites, weight loss
- Often asymptomatic and found incidentally
๐ Investigations
- Bloods: FBC, U&E, LFTs, CRP
- Tumour markers: CEA, CA 19-9, CA 125
- CT abdomen and staging scans
๐ Management
- Discuss in oncology & surgical MDT
- Many cases are only diagnosed after an initial appendicectomy
- Right hemicolectomy if:
- Carcinoid tumour >2 cm
- Smaller tumour with mesoappendiceal invasion
- Chemotherapy may have a role in adenocarcinoma or advanced disease
- Overall prognosis is excellent for localized disease ๐
๐ References