Neoplasms of the Appendix
posted in The Aging Liver |The most common tumor of !he appendix is a carcinoid tumor, which is found in about 1 in 1000 resected appendixes. Rarely malignant, carcinoid tumors are treated by appendectomy. If Ihey are > 2 cm in diameter or show evidence of lymphatic or lymph node involvement, a right colectomy should be performed.
Primary adenocarcinoma of the appendix is rare, even though the appendix is lined with colonic mucosa. This tumor may block the lumen, leading to acute appendicitis and perforation.
Mucoceles produce appendiceal distention and outlet obstruction because of the intraluminal accumulation of mucus. The symptoms suggest early appendicitis. A mucocele may be demonstrated by CT scan. Although mucoceles are usually benign and treatable by appendectomy, some are associated with low-grade adenocarcinoma; if these mucoceles perforate, a form of carcinomatosis known as pseudomyxoma peritonei results. Palients who have this indolent tumor present with increased abdominal girth and a doughy abdomen. They can survive for several years, but repeated accumulation of intraperitoneal mucus or intestinal obstruction occurs. Palliative surgery often prolongs life and makes the patient more comfortable.
