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

• Author Details:   
• Ridham . ^*
• Amit Aggarwal
• Anish Bhatia
• Davinder Paul
• Shivani Garg

---

View PDF

Appendiceal neuroendocrine tumors (ANETs) occur in less than 1% of surgical resections. Grossly it is difficult to differentiate malignant tumor from benign conditions and clinically patients often present as asymptomatic or with symptoms like lower abdominal pain, nausea, vomiting etc. Present scenerio 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 and 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 (meso-appendiceal spread). The final diagnosis of metastatic lymph node deposits in known case of neuroendocrine tumor (pT3 pN1 M0) was made. Based on the above findings, proper evaluation of appendix should be done during gynaecological surgeries and appendecetomy should be performed if needed. Imparting training of appendectomy to gynaecological surgeons is recommended for early diagnosis and treatment of appendical neuroendocrine tumor.