Progression to pseudomyxoma peritonei in patients with low grade appendiceal mucinous neoplasms discovered at time of appendectomy.

Publication Title

American journal of surgery

Authors

Shelby Reiter, Department of General Surgery, Swedish Medical Center First HillFollow
Colin J Rog, Department of Surgery, Division of Surgical Oncology, Swedish Medical Center, 747 Broadway, Heath 10, Suite 1003, Seattle, WA, 98122, USAFollow
Mohamed Alassas, Department of Surgery, Division of Surgical Oncology, Swedish Medical Center, 747 Broadway, Heath 10, Suite 1003, Seattle, WA, 98122, USAFollow
Evan Ong, Swedish Medical Center, Seattle, WA.Follow

Document Type

Article

Publication Date

12-3-2021

Keywords

washington; seattle; swedish

Abstract

BACKGROUND: The discovery of a low grade appendiceal mucinous neoplasm (LAMN) during appendectomy is a rare scenario. These neoplasms can progress to pseudomyxoma peritonei (PMP), however the incidence of progression is not well known.

METHODS: The records of all patients with a diagnosis of localized LAMN found during appendectomy were identified, and demographic, tumor, surveillance, and outcome variables were analyzed.

RESULTS: Progression to PMP occurred in 20% of patients in an average of 12.4 months after appendectomy with median follow-up of 18 months. Tumor variables such as margin positivity, appendiceal perforation, and presence of extra-appendiceal acellular mucin or mucinous epithelium on the serosal were not significantly associated with progression.

CONCLUSIONS: During an average follow-up period of 18 months after surgery, progression to PMP occurred in a fifth of patients. It is difficult to predict which patients will progress, therefore cross-sectional imaging surveillance is recommended for all patients.

Clinical Institute

Digestive Health

Clinical Institute

Cancer

Specialty/Research Institute

Gastroenterology

Specialty/Research Institute

Oncology

Specialty/Research Institute

Surgery