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PubMedDate not supplied

Carcinoma of colon and appendix related to faecal stasis.

It is widely accepted that carcinoma of the large bowel is common in the Western world because we eat a low residue diet which causes faecal stasis. The part of the large bowel with the most stasis is the appendix, which has similar mucosa; but the incidence of carcinoma per unit area of appendicular mucosa is four times less than carcinoma per unit area of large bowel. Therefore, faecal stasis is probably not important in the aetiology of carcinoma of the appendix.

Adult↗
PubMed1983

[Adenocarcinoma of the appendix. Apropos of 11 new cases].

The authors review 11 new cases of adenocarcinoma of the appendix and 220 other cases drawn from the literature. In the first series, 6 patients presented with abscess or perforations. The tumor was proximal in 5, distal in 2, medial in 2, and total in 2. It extended to the cecum in 4 cases and to the lymph nodes in two. The clinical picture was one of appendicitis in seven patients, an iliac growth in three and occlusion in one. The diagnosis was made by the surgeon in four cases, and by postoperative histological examination in seven. The authors stress the need to open the appendix at operation, to take frozen sections in the event of any doubts, and systematic postoperative histological examination of operative specimens. Appendectomy is a poor solution, even accompanied by partial cecectomy, the survival rate at five years being only 20 %. It is only licit for a unperforated, proximal mucosal or submucosal tumor. The best solution is immediate or secondary right hemicolectomy, for which the survival rate, of 45 % at five years, is close to that of other forms of colic cancers.

Adenocarcinoma↗
PubMed1978

Mucinous carcinoid and endometriosis in an inside-out appendix.

This is the first report of the simultaneous occurrence of mucinous carcinoid and endometriosis in an inside-out appendix. The literature concerning carcinoids, endometriosis and intussusception of the appendix is reviewed. The mucinous, or goblet cell carcinoid was positive for mucin, argentaffin and argyrophil stains. Paneth cells were present. Two and one-half years with no tumor recurrence suggest good prognosis as previously reported.

Adult↗
PubMed1983

Relationship between the removal of the nonacute appendix and the menstrual cycle.

The significantly higher incidence of removal of a normal appendix in females in the second, third and fourth decades of life for suspected acute appendicitis lead to a study of the frequency of appendicectomy and the peroperative findings at the time of surgery in patients in different phases of the menstrual cycle. The results showed that the frequency of acute appendicitis in the luteal phase was more than twice the frequency of the disease in the remaining half of the menstrual cycle. Further, there was a significantly higher proportion of gangrenous, perforated and normal appendices removed from patients in the menstrual and follicular phases of the menstrual cycle. The diseases mimicking acute appendicitis are tabulated. From these results it can be concluded that the female sex hormones might play an important aetiological role in the development of acute appendicitis or influence the inflammatory process in the appendix.

Adolescent↗
PubMed1983

Primary adenocarcinoma of the appendix. Can preoperative or intraoperative diagnosis be made?

Adenocarcinoma of the appendix is a rare entity with a reported incidence of .03 to .08 per cent. A review of all appendectomies performed at St. Joseph Mercy Hospital (a private community hospital) between 1963 and 1979 was undertaken to assess the efficacy of preoperative diagnosis. Six adenocarcinomas were found, consisting of five male patients and one female patient with a mean age of 65 years. Symptoms were present for 24 hours or greater in all cases. A preoperative diagnosis was not made in any patient. Three patients later required a definitive therapeutic procedure, and two patients died from metastatic disease during their initial hospitalization. The literature was reviewed to evaluate methods of preoperative and intraoperative diagnosis of appendical adenocarcinoma. A suspicion of carcinoma of the appendix should be entertained for patients over the age of 50 years who present with signs and symptoms of appendicitis for greater than 24 hours. A barium enema performed preoperatively and especially a frozen section at the time of surgery of any suspicious appendiceal lesions may improve the diagnostic accuracy and survival of patients with this disease entity. If preoperative or intraoperative diagnosis is made, the patient can be better prepared and definitive surgical therapy carried out. This avoids delay in treatment and a second operative procedure.

Adenocarcinoma↗
PubMed1983

[An autopsy case of pancreatic cancer with carcinoid tumor of the appendix].

A 78-year-old man with pancreatic carcinoma with carcinoid tumor of the appendix is reported. Upon autopsy, the tumor consisted of poorly differentiated adenocarcinoma with scirrhous-like spreading. In the appendix a carcinoid tumor, size measuring 2 mm X 1 mm, was seen; the carcinoid cells were argentaffin.

Adenocarcinoma↗
PubMed1982

Carcinoid tumours of the appendix: 21 cases, with a review of the literature.

Twenty-one carcinoid tumours of the appendix are reviewed. These represented 77 percent of all appendiceal primary tumours over a 16 year period and presented at a mean age of 32.3 years. No difference in sex incidence or significant racial trends were revealed. Discovery of the tumour followed presentation as appendicitis in most cases (14) and was incidental after routine appendicectomy at laparotomy in the rest. Most tumours were less than 2 cm in diameter, and five involved the appendix wall diffusely. All were argentaffin and contained significant areas of type A histological pattern. Lymphatic permeation was noted in nearly half the cases and invasion of the mesoappendix in 33 percent. Treatment was by simple appendicectomy in nineteen patients, appendicectomy with removal of a wedge of caecum in one, and right hemicolectomy in another. The literature is reviewed.

Adolescent↗
PubMed1995

Acute appendicitis: does removal of a normal appendix matter, what is the value of diagnostic accuracy and is surgical delay important?

A prospective study with long-term follow-up was undertaken of 248 patients (137 males, median age 18 years (range 6-81 years), undergoing emergency appendicectomy during a 12-month period. Acute inflammation was present in 182 patients (73.4%) (males 86.1%, females 57.8%; P < 0.001). Before surgery, the positive predictive value of diagnostic accuracy was 82.0% (males 91.2%, females 67.7%). Delaying surgery did not significantly increase the proportion of perforated appendices (22.0%), hospital stay, or frequency of postoperative complications (overall 49.6%). Hospital complications were significantly more common among patients with a perforated appendix. There was no significant difference in the complication rate between patients with or without appendicitis while in hospital, during the first 18 months after operation or 8 years after operation. At 18 months, 17 of 238 patients (7.1%) continued to experience their original pain. After 8 years the original pain was still present in 10 of 155 patients (6.5%). Continued pain was more likely in patients having undergone removal of a normal appendix (P < 0.001)

Abdominal Pain↗
PubMed1995

Expression of cytokeratin 7 in simultaneous mucinous tumors of the ovary and appendix.

Cytokeratin 7 (CK-7) is a simple epithelial keratin that may be used to investigate the site of origin of adenocarcinomas. In fact, CK-7 is present in ovarian epithelial neoplasms but is generally absent in colonic carcinomas. This pattern of CK-7 expression may aid in elucidating the genesis of mucinous tumors occurring simultaneously in the ovary and appendix, accompanied by psuedomyxoma peritonei. Five such cases were immunostained with anti-CK-7, and all showed a concordant staining pattern of the appendiceal, ovarian, and peritoneal lesions. Two cases showed a negative reaction for CK-7 and thus would appear to represent ovarian and peritoneal metastases from an appendiceal primary tumor. Three cases were CK-7 positive, and the nature of these mucinous lesions remains open to debate; they may either represent independent primary tumors or originate from the appendix. For comparison, five Stage I mucinous borderline tumors of the ovary and their normal appendices were also stained with anti-CK-7. These ovarian tumors were all CK-7 positive, whereas the appendices were negative. It is concluded that CK-7 is capable of distinguishing a group of tumors that can reliably be classified as primary appendiceal neoplasms metastatic to the ovaries and peritoneum.

Adult↗
PubMed1995

Psoas abscess due to mucinous cystadenocarcinoma of the appendix: a case report.

Psoas muscle abscess is an uncommon and challenging entity. The present report describes a 64-year-old man presenting with right flank mass. Abdominal computerized tomography showed a right psoas abscess. Extraperitoneal drainage was performed, and pathology revealed metastatic mucinous adenocarcinoma. After further study, laparotomy and right hemicolectomy were performed under the impression of colon cancer. The final pathology showed mucinous cystadenocarcinoma of appendix. The literature about the etiology, diagnosis and treatment of psoas abscess are reviewed. Additionally, the treatment and prognosis for mucinous cystadenocarcinoma of the appendix are noted.

Appendiceal Neoplasms↗
PubMed1994

[Clinical study on torsion of appendix in intrascrotal organ].

We reviewed 12 cases of torsion of appendix in the intrascrotal organ treated surgically and discussed its clinical features. An accurate diagnosis could be made in 5 of the 12 patients before operation because they had a palpable localized tender nodule at the affected area, but not in the other 7 patients because their whole scrotal contents had become swollen with time. The histological study on 6 patients with testicular swelling revealed their spermatogenesis intact. Therefore, we believe that torsion of the appendix in the intrascrotal organ has little influence on future fertility, and thus, correct preoperative diagnosis may diminish the necessity for surgical treatment.

Adult↗
PubMedDate not supplied

[Crohn's disease of the appendix: a rare nosological entity].

In this study, the authors describe a case of Crohn's disease confined to the vermiform appendix out of a total of 1,263 appendectomies performed over the past 10 years in a Clinical Surgery Department (Clinica Chirurgica III) of the Policlinico S. Orsola in Bologna. In agreement with other reports in the scientific literature, the essentially non-specific clinical picture prevents pre-operative identification of the condition, whereas a diagnosis of Crohn's disease can be reached only on the basis of histological characteristics. The extreme rarity of Crohn's disease confined to the appendix is, however, confirmed. Follow-up at 3 years revealed no involvement of other areas of the digestive tract.

Adult↗
PubMed1993

Indications for right hemicolectomy in carcinoid tumors of the appendix. The French Associations for Surgical Research.

The records of 181 patients with carcinoid tumor of the appendix, seen during a ten year period (1977 to 1987), were analyzed retrospectively to determine the indications for right colectomy and the signification of intermediate histopathologic forms. Appendectomy was the only treatment in 146 patients; while right hemicolectomy was performed upon 35 patients--in seven patients with one postoperative death initially and in 28 patients without any death or morbidity, secondarily. Colectomy was indicated initially in seven patients for bulky tumors of the base of the appendix invading the cecum or for associated carcinoma of the right colon. The 28 secondary colectomies were indicated for tumors that were statistically larger and more invasive than those treated by simple appendectomy or for intermediate forms, or both, in five instances. There were five instances of residual tumor on secondary hemicolectomy specimens. In 11 of the 181 carcinoid tumors (6 percent), the intermediate type tumor was associated with mucinous production--seven adenocarcinoids and four carcinoids with mucocele. Of the seven instances of adenocarcinoid, there was one death at two years and one patient is alive with metastases. Other than size greater than 2 centimeters and base localization, the results of the current study suggest that the presence of mucinous production cells is a further indication for secondary right hemicolectomy.

Adolescent↗
PubMed1993

[Primary malignant lymphoma in the appendix vermiformis].

Primary gastrointestinal lymphoma (PGL) is a rare condition. A case story concerning a 17 year old boy is presented and discussed. The symptoms were fever and pain in the lower right quadrant of the abdomen, where a tender tumor was palpable. The tentative diagnosis was periappendicular abscess and the patient was treated with antibiotics. As the tumor persisted, a laparotomy with resection of the coecum was performed. Histologic diagnosis was malignant lymphoma originating in the appendix. There was no sign of dissemination in the abdomen. Postoperative treatment with chemotherapy and radiation was carried out. PGL in the appendix in young patients, almost entirely males, will as here often be of the Burkitt type. The histologic type of the tumor, the staging and the radicality at operation are important with regard to prognosis.

Adolescent↗
PubMed1993

[Carcinoid tumors of the appendix. Review of the literature and two case reports].

Gastrointestinal carcinoids are infrequent but at the same time hardly rare tumours. They are often chance findings but, as is clearly reported in the literature, their potential malignancy should not be overlooked. They are most commonly localised in the appendix. The authors describe two case reports of carcinoid tumours of the appendix, one of which was diagnosed during left hemicolectomy due to Crohn's disease and the other during acute appendicitis. Prognostic and therapeutic problems are discussed in the light of the most recent literature.

Adult↗
PubMed1996

[Adenocarcinoma of the appendix. A propos of a case complicated by double local and parietal recurrence].

Adenocarcinoma of the appendix is rarely encountered and is usually discovered fortuitously at pathology examination of the surgical specimen. Six years after surgery for degenerative villous tumor of the appendix, local and parietal recurrence led to surgery in our patient. We present here the indications for complementary hemicolectomy and management of parietal scars resulting from the initial appendectomy.

Adenocarcinoma, Mucinous↗
PubMed1992

The 'absent' appendix.

During an operation for suspected appendicitis, the surgeon concluded that the appendix was absent. The causes of this situation are presented and a guide to its management is suggested.

Abdominal Pain↗