An incidental finding of ANET in a patient with perforated appendix: A case report. (December 2021)

• Record Type: Journal Article
• Authors: Basukala, Sunil; Bhusal, Ujwal; Sharma, Shriya; Tamang, Ayush; Gurung, Suman
• Is Part Of: International journal of surgery case reports. Volume 89(2021)
• Publication Date: 2021-12
• Subjects: Appendiceal neoplasms -- Neuroendocrine tumor -- Perforated appendicitis -- Case report; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2021.106625
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Introduction and importance: Appendiceal neuroendocrine tumors (ANETs) are incidentally found in 0.2–0.7% of appendectomies for suspected appendicitis. Case presentation: A 29-year-old female presented with pain in the right lower quadrant of her abdomen for the past 48 h. On emergency appendectomy for suspected acute appendicitis, a perforated appendix was found. Histopathological examination showed grade 1 (low) ANET. Clinical discussion: Appendiceal neuroendocrine neoplasms (ANENs) are commonly found at the tip of the appendix and are treated with appendectomy alone. For few ANENs located at the base, or small tumors (≤2 cm) infiltrating the submucosa, the muscularis, the subserosa layer or the mesoappendix, right hemicolectomy is recommended. However, no guidelines have been established concerning patients with appendiceal perforation in case of ANENs. Conclusion: Although rare, ANETs should be considered in the differential diagnosis of acute appendicitis. Since, ANETs are rarely diagnosed preoperatively, subsequent patient evaluation after appendectomy is crucial for management of the patient. Highlights: Appendiceal Neuroendocrine tumor (ANET) are incidentally found in 0.2–0.7% of appendectomies for suspected appendicitis. ANETs are commonly found at the tip of the appendix and are treated with appendectomy alone. Although rare, ANETs should be considered in the differential diagnosis of acute appendicitis. Since, ANETs are rarely diagnosed preoperatively, subsequent patient evaluation after appendectomy is crucial. The best management of ANETs in case of perforated appendicitis remains unclear.