Neoplasms of the Appendix: Carcinoid Tumor and Adenocarcinoma

Neoplasms of the Appendix

• Carcinoid tumor: small, firm, and bright yellow in color due to lipoid content, secretes serotonin and other peptides.
• Carcinoid tumor: usually asymptomatic, discovered during operation, with rare metastasis leading to carcinoid syndrome.
• Treatment of carcinoid tumor: appendicectomy is the treatment of choice, unless lymph nodes are involved, in which case right hemicolectomy is indicated.

Adenocarcinoma

• Adenocarcinoma: second most common tumor of the appendix, often presents as acute appendicitis or intestinal obstruction.
• Treatment of adenocarcinoma: right hemicolectomy.

Malignant Mucocele

• Malignant mucocele: mucous papillary adenocarcinoma, may arise from benign mucocele in acute appendicitis.
• Treatment of malignant mucocele: simple appendicectomy.
• Complication of malignant mucocele: rupture of mucous-filled appendix during operation can lead to pseudomyxoma peritonei.

Pseudomyxoma Peritonei

• Pseudomyxoma peritonei: accumulation of mucinous fluid or gelatinous material in the peritoneal cavity, also occurs after rupture of a pseudomucinous cyst of the ovary.
• Treatment of pseudomyxoma peritonei: surgical removal of pseudomucin and underlying tumor, followed by peritoneal toilet.

Differential Diagnosis of a Mass in Right Iliac Fossa

• Possible anatomical structures in the region: • Appendicular mass or abscess • Carcinoma cecum • Crohn's disease • Ileocaecal tuberculosis • Mesenteric lymphadenitis • Ovarian or tubal mass • Retroperitoneal tumor • Pelvic kidney

Indications for Abandoning Conservative Treatment

• Rising pulse rate in early stages
• Persistent, sustained fever over 36 hours
• Persistent pain
• Increase in size of the mass or area of tenderness
• Developing intestinal obstruction