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Ann Surg Oncol. 2017 Jul;24(7):1778-1782. doi: 10.1245/s10434-016-5623-3. Epub 2017 May 4.

Computed Tomography Follow-Up Assessment of Patients with Low-Grade Appendiceal Mucinous Neoplasms: Evaluation of Risk for Pseudomyxoma Peritonei.

Author information

1
Department of Surgery and Centre for Clinical Research of Uppsala University, Västmanland's Hospital, Västerås, Sweden. catarina.tiselius@ltv.se.
2
Department of Surgery, Västmanland's Hospital Västerås, Västerås, Sweden. catarina.tiselius@ltv.se.
3
Department of Pathology, Västmanland's Hospital, Västerås, Sweden.
4
Department of Oncology, Västmanland's Hospital, Västerås, Sweden.
5
Department of Surgery and Centre for Clinical Research of Uppsala University, Västmanland's Hospital, Västerås, Sweden.

Abstract

BACKGROUND:

Low-grade appendiceal mucinous neoplasms are rare. Both classification and management vary. This study aimed to follow up on patients with a diagnosis of LAMN after primary surgery with computer tomography (CT) scans to examine the risk for the development of pseudomyxoma peritonei (PMP).

METHODS:

This population-based prospective study investigated patients who underwent appendectomy between 2007 and 2013 and had histology results demonstrating the presence of LAMN. The patients were followed up with a CT scan every 6 months for 2 years, until December 2015.

RESULTS:

The study investigated 41 patients (20 females) with a median age of 65 years (range 20-87 years). The entire appendix was processed and examined, with results showing that 12 were perforated, and 3 had a positive margin. Extra-appendiceal mucin on the surface of the appendix was found in ten cases, and in two cases, extra-mucinous epithelial cells were detected. During a median follow-up period of 5.1 years (range 2-8.6 years), none of the patients experienced the development of PMP.

CONCLUSIONS:

These data suggest that for patients with LAMN confined to the appendix, involvement of the appendectomy margin or perforation with mucin locally, even with epithelial cells, did not predict the development of PMP, and a conservative approach seems justified. No reoperation was needed, and regular follow-up evaluation with CT scans was sufficient.

PMID:
28474197
DOI:
10.1245/s10434-016-5623-3
[Indexed for MEDLINE]

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