Abstract
Introduction: Appendiceal carcinoids are very difficult to diagnose pre-operatively since they are uncommon and have no typical presentation. Hence, they are detected during appendectomy or other abdominal surgeries or more commonly on histopathological analysis of appendectomy specimens. In this study, we aim for retrospective analysis of the incidence and characteristics of carcinoid tumours of the appendix.
Methods: The case records of all the patient's aged 18 years and above, who underwent emergency or elective, laparoscopic or open appendectomy between January 1st 2010 to December 31st 2020 at a tertiary care centre in Mumbai after obtaining institutional ethics committee approval, were included in an observational retrospective study. Demographic data like age, sex and tumour characteristics like size of the tumour, location of the tumour in the appendix (tip/body/base), grade, site of perforation (if perforated), infiltration of vessels, infiltration of mesoappendix and immunohistochemical characteristics were noted.
Results: A total number of 4485 appendectomies were performed during the study period. Carcinoid tumour was found on histopathological examination in 6 specimens which accounts for 0.133 % incidence. Only one of them was male (16.66%) and the rest five were females (83.33 %). The mean age was 24.16 years with the range being 19-30 years. All patients were operated on for acute appendicitis and none was suspected to have carcinoid tumour preoperatively. Histologically, all tumours were located at the tip with the mean diameter being 0.98 cm (range 0.2-2 cm). All the tumours were grade 1 and none of them had a lymphovascular invasion. Only 2 out of 6 tumours had focal subserosal fat infiltration of the mesoappendix.
Conclusion: The incidence of appendiceal carcinoid in our study was 0.133%. They do not have specific clinical features and present as acute appendicitis. Hence, they are usually diagnosed after surgery on histopathological evaluation. The size of the tumour plays an important role in treatment and prognosis.