A 25-year review of adenocarcinoma of the appendix. A frequently perforating carcinoma

Cerame MA, M A Cerame
Diseases of the colon and rectum · 1988 · vol. 31(2) , pp. 145–50 · doi:10.1007/bf02562650 · PMID:3276467
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This 25-year review of 316 appendix adenocarcinoma cases reports a male predominance, frequent preoperative misdiagnosis as inflammation, and high perforation rates, noting that pseudomyxoma peritonei and carcinomatosis peritonei indicate poor prognosis.

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This study analyzed 316 case reports and collective reviews to compare the clinical characteristics of appendiceal adenocarcinoma with those of colon adenocarcinoma. The findings indicated that the disease predominantly affects males, with a mean patient age of 57.1 years, and is frequently misdiagnosed as inflammatory appendicitis prior to surgery. Perforation occurred in more than half of the cases, often resulting in localized abscesses rather than immediate poor prognosis, although pseudomyxoma peritonei and carcinomatosis peritonei were associated with significantly worse survival outcomes. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

A study was undertaken to compare the age, sex, preoperative diagnosis, and operative findings of patients who had adenocarcinoma of the appendix with patients who had adenocarcinoma of the colon. The study consisted of an analysis of 316 case reports and collective reviews of adenocarcinoma of the appendix that were reported in the literature between 1960 and 1985. The mean age of patients with this disease was 57.1 years and the male-to-female ratio for adenocarcinoma of the appendix was 1.4:1. Only rarely was a malignancy suspected, as 68 percent of the patients presented with signs and symptoms of inflammatory disease of the appendix. The tumor was perforated in 55 percent of patients, making it the most frequently perforating carcinoma of the entire gastrointestinal tract. One half of these perforations were localized as abscesses. The presence of perforation did not necessarily predispose a poor prognosis. Synchronous appendiceal and other colonic neoplasms occurred in 2.7 percent of patients. Pseudomyxoma peritonei occurred as a presenting feature in 5.6 percent of patients and was generally a poor prognostic indicator. Carcinomatosis peritonei was found at initial exploration in 10.3 percent of patients and these patients rarely survived one year.
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A 25-year review of adenocarcinoma of the appendix A frequently perforating carcinoma - Mario A. Cerame A study was undertaken to compare the age, sex, preoperative diagnosis, and operative findings of patients who had adenocarcinoma of the appendix with patients who had adenocarcinoma of the colon. The study consisted of an analysis of 316 case reports and collective reviews of adenocarcinoma of the appendix that were reported in the literature between 1960 and 1985. The mean age of patients with this disease was 57.1 years and the male-to-female ratio for adenocarcinoma of the appendix was 1.4:1. Only rarely was a malignancy suspected as 68 percent of the patients presented with signs and symptoms of inflammatory disease of the appendix. The tumor was perforated in 55 percent of patients, making it the most frequently perforating carcinoma of the entire gastrointestinal tract. One half of these perforations were localized as abscesses. The presence of perforation did not necessarily predispose a poor prognosis. Synchronous appendiceal and other colonic neoplasms occurred in 2.7 percent of patients. Pseudomyxoma peritonei occurred as a presenting feature in 5.6 percent of patients and was generally a poor prognostic indicator. Carcinomatosis peritonei was found at initial exploration in 10.3 percent of patients and these patients rarely survived one year.

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MeSH descriptors

Adenocarcinoma Adenocarcinoma Adenocarcinoma Adenocarcinoma Appendiceal Neoplasms Appendiceal Neoplasms Appendiceal Neoplasms Appendiceal Neoplasms Abscess Abscess Adolescent Adult Aged Aged, 80 and over Colonic Neoplasms Colonic Neoplasms Colonic Neoplasms Female Humans Intestinal Perforation

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