Appendiceal neuroendocrine tumors (ANETs)- incidental finding on frozen section of hysterectomy specimen.

Authors: Ridham Ridham, Amit Aggarwal, Anish Bhatia, Davinder Paul, Shivani Garg

DOI: 10.18231/j.ijpo.7872.1069174083

Keywords: Appendiceal neuroendocrine tumors, colectomy, neoplasm grading.,frozen section

Abstract: Appendiceal neuroendocrine tumors (ANETs) occur in less then 1 % of surgical resections. Patient symptoms can range from asymptomatic to acute appendicitis, lower abdominal pain and these tumors are often diagnosed after histopathological evaluation. This case study describes appendiceal neuroendocrine tumor diagnosed as an incidental finding on frozen section of hysterectomy specimen. Appendix was enlarged and edematous appendix, densely adherent to right fallopian tube. Hard lump was noted at tip of appendix , frozen section and histopathological diagnosis favors Neuroendocrine tumor of appendix . Immunohistochemistry results showed positivity for synaptophysin and chromogranin with Ki- 67 index of 1-2 %.Based on the CECT findings after hysterectomy and histopathological report patient was planned for right hemicolectomy ( mesoappendiceal spread). The final diagnosis of metastatic lymph node deposits in known case of Neuroendocrine Tumor (appendix)(Stage pN1) was made. As a result of these findings, it is recommended that the appendix should be routinely evaluated during gynecologic surgeries and, if abnormal in appearance, appendectomy should be performed. Additionally, laparoscopic gynecologic surgeons should receive appendectomy training to aid with the early diagnosis and treatment of appendiceal neuroendocrine tumors.