KaydedilenlerDerginizi ekleyin

Dergiler / Batı Karadeniz Tıp Dergisi / 2024 / Cilt: 8 Sayı: 3

Tesadüfen Tespit Edilen Appendisal Nöroendokrin Tümörlerde (aNET) İnvaziv Histolojik Özelliklerin Klinikopatolojik Korelasyonu

Clinicopathological Correlation of Invasive Histological Features in Incidentally Detected Appendiceal Neuroendocrine Tumors (aNETs)

Ceren Sayar(Alsancak Nevvar Salih İşgören Devlet Hastanesi)0000-0002-9590-4699
Haldun Umudum(Ankara Güven Hastanesi)0000-0002-4550-1971
Recep Bedir(RECEP TAYYİP ERDOĞAN ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0001-8247-3781
Zafer Turan(Artvin Devlet Hastanesi)0000-0002-8071-856X
Sayfa
291–298
Yayın Tarihi
2024-12-30
🏛️Bu makalenin bibliyografik verileri ve tam metin bağlantısı DergiPark üzerinden sağlanmıştır.
DergiPark Kaydı ↗
✨

Yapay Zeka Hızlı Bakış & Çıkarımlar

AI Insight
⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Bulgular: Tümörlü olguların yaş ortalaması 41'dir (11-61).

📌 3 Maddede Bu Makale

🎯
Amaç & Hipotez:Amaç: Apendiks Nöroendokrin Tümörleri (aNET'ler) nadir görülen ve çoğunlukla akut apandisit nedeniyle ameliyat edilen hastalarda tesadüfen saptanan tümörlerdir.
📊
Temel Bulgular & Veri:Bulgular: Tümörlü olguların yaş ortalaması 41'dir (11-61).
💡
Sonuç & Katkı:Bu bireyler için düzenli takip aralıklarının sürdürülmesinin akıllıca olacağına inanıyoruz.
🔬Tür:Literatür & Derleme Çalışması
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Appendiks · nöroendokrin tümörler · invaziv histolojik özellikler

Özet

Amaç: Apendiks Nöroendokrin Tümörleri (aNET'ler) nadir görülen ve çoğunlukla akut apandisit nedeniyle ameliyat edilen hastalarda tesadüfen saptanan tümörlerdir. Bunlar yavaş ilerleyen ve çoğunlukla iyi huylu tümörlerdir ancak metastaz riski taşırlar. Bu çalışma, ANET vakalarının evre ve derecelendirme parametreleri dışındaki agresif davranışlarla ilişkili invazif histolojik özelliklerini tanımlamayı amaçlamaktadır. Gereç ve Yöntemler: Bu retrospektif çalışma hasta demografik özelliklerini, cerrahi sınır durumunu ve tümörlerin patolojik özelliklerini içermektedir. Adenokarsinom özellikleri, goblet hücresi özellikleri ve karma özellikler gösteren ANET'ler çalışmamıza dahil edilmedi. Bulgular: Tümörlü olguların yaş ortalaması 41'dir (11-61). Ortalama tümör çapı 6,8 mm olarak bulundu. Tümörlerin çoğu distal apendiks yerleşimlidir (55.5%). Tümörlerin tamamı invaziv özellik göstermektedir. Dört vakada submukozaya (pT₁), dört vakada muskularis propriaya (pT₁), sekiz vakada subserozaya (pT₃) ve dört vakada mezoapendikse (pT₃) invazyon görüldü. Sadece 2.derece özellikleri ve MAI'si olan bir olgu için takip bilgisi mevcuttu, ek cerrahi tedaviye gerek duyulmadı ve 3 yıllık takipte metastaz olmaksızın hayatta kaldı. Sonuç: Birinci derece ve evre-1 tümörler olsa bile metastaz riski taşıyan invaziv özellikler gösterebilir. LVI ve PNI ANET evrelemesinde yer almasa da hastalığın seyrini etkileyen önemli faktörlerdir. Literatürde invaziv histolojik özellikler sergileyen hastalarda tamamlayıcı sağ hemikolektomi yapılmasının tavsiye edilebilirliği konusunda fikir birliği yoktur. Bu bireyler için düzenli takip aralıklarının sürdürülmesinin akıllıca olacağına inanıyoruz.

Abstract

Aim: Appendiceal Neuroendocrine Tumors (aNETs) are rare and mostly detected incidentally patients operated on acute appendicitis. These are indolent tumors and mostly benign, however they carry risk of metastasis. This study aims to identify invasive histological features of aNET cases, that are correlated with aggressive behavior other than stage and grading parameters. Material and Methods: This retrospective study includes patient demographics, surgical margin status and pathological features of tumors. ANETs showing adenocarcinoma features, goblet cell features, and mixed features were not included in our study. Results: The mean age of cases with tumors is 41years (11-61 years). The mean tumor diameter was found to be 6.8 mm. Most of tumors were located in the distal appendix (55.5%). All of the tumors show invasive features. Four cases showed invasion to submucosa (pT₁), four cases to muscularis propria (pT₁), eight cases to subserosa (pT₃), and four cases to mesoappendix (pT₃). Follow-up information was available for only one case with Grade-2 features and MAI, no additional surgical treatment was required, and he has survived at 3-year follow-up with no metastasis. Conclusion: Even if it is grade 1stage 1 tumors, may exhibit invasive features with a risk of metastasis. Although LVI and PNI are not included in ANET staging, they are important factors affecting the course of the disease. The literature lacks consensus on the advisability of performing completion right hemicolectomy in patients exhibiting invasive histological features. We believe it prudent to maintain regular follow-up intervals for these individuals

🔖

Bu Makaleye Atıf Yap

Sayar, C., Umudum, H., Bedir, R., Turan, Z. (2024). Tesadüfen Tespit Edilen Appendisal Nöroendokrin Tümörlerde (aNET) İnvaziv Histolojik Özelliklerin Klinikopatolojik Korelasyonu. Batı Karadeniz Tıp Dergisi, Cilt: 8 Sayı: 3, 291–298. https://doi.org/10.29058/mjwbs.1449624

📄 Tam Metin PDF Okuyucu

📄

PDF görüntüleyici hazırlanıyor...

Kaynakça (31)

  1. Terzioğlu SG, Kılıç MÖ, Öksüz P, Gürer A. Appendiceal neuroendocrine neoplasia: analysis of 50 patients. Cir Cir. 2022;90(92):75-80.
  2. Bayhan Z, Yildiz YA, Akdeniz Y, Gonullu E, Altintoprak F, Mantoglu B, vd. Appendix Neuroendocrine Tumor: Retrospective Analysis of 4026 Appendectomy Patients in a Single Center. Emerg Med Int. 2020;2020:4030527.
  3. Connor SJ, Hanna GB, Frizelle FA. Appendiceal tumors: retrospective clinicopathologic analysis of appendiceal tumors from 7,970 appendectomies. Dis Colon Rectum. 1998;41(1):75-80.
  4. Demiral G, Çolakoğlu MK, Kalcan S, Özdemir A, Demir A, Pergel A. Incidental appendix neuroendocrine tumor and current treatment approach in patients with acute appendicitis. Acta Oncol Turc. 2018;51(1):17-20.
  5. Eğin S, Kamalı G, Kamalı S, Gökçek B, Yeşiltaş M, Hot S, vd. Neuroendocrine tumor of the appendix: Twelve years of results from a single institution. Ulus Travma Ve Acil Cerrahi Derg Turk J Trauma Emerg Surg TJTES. 2019;25(2):118-22.
  6. Cañizares Quisiguiña SI, Guamán Maldonado LV, Hidalgo Jaramillo IM, Borja Herrera TP, Carrión Guzmán C de LÁ. Incidental neuroendocrine tumor of a complete subserosal appendix: an unusual presentation of a rare anatomical variation. A case report and review of literature. BMC Surg. 2021;21(1):421.
  7. Landry JP, Voros BA, Ramirez RA, Boudreaux JP, Woltering EA, Thiagarajan R. Management of Appendiceal Neuroendocrine Tumors: Metastatic Potential of Small Tumors. Ann Surg Oncol. 2021;28(2):751-7.
  8. Pape UF, Niederle B, Costa F, Gross D, Kelestimur F, Kianmanesh R, vd. ENETS Consensus Guidelines for Neuroendocrine Neoplasms of the Appendix (Excluding Goblet Cell Carcinomas). Neuroendocrinology. 2016;103(2):144-52.
  9. Kleiman DA, Finnerty B, Beninato T, Zarnegar R, Nandakumar G, Fahey TJ, vd. Features Associated With Metastases Among Well-Differentiated Neuroendocrine (Carcinoid) Tumors of the Appendix: The Significance of Small Vessel Invasion in Addition to Size. Dis Colon Rectum. 2015;58(12):1137-43.
  10. Sommer C, Gumy Pause F, Diezi M, Rougemont AL, Wildhaber BE. A National Long-Term Study of Neuroendocrine Tumors of the Appendix in Children: Are We Too Aggressive? Eur J Pediatr Surg Off J Austrian Assoc Pediatr Surg Al Z Kinderchir. Ekim 2019;29(5):449-57.
  11. Wu H, Chintagumpala M, Hicks J, Nuchtern JG, Okcu MF, Venkatramani R. Neuroendocrine Tumor of the Appendix in Children. J Pediatr Hematol Oncol. 2017;39(2):97-102.
  12. Alkhayyat M, Saleh MA, Coronado W, Abureesh M, Zmaili M, Qapaja T, vd. Epidemiology of neuroendocrine tumors of the appendix in the USA: a population-based national study (2014- 2019). Ann Gastroenterol. 2021;34(5):713-20.
  13. Mullen JT, Savarese DMF. Carcinoid tumors of the appendix: a population-based study. J Surg Oncol. 2011;104(1):41-4.
  14. Moertel CG, Weiland LH, Nagorney DM, Dockerty MB. Carcinoid tumor of the appendix: treatment and prognosis. N Engl J Med. 1987;317(27):1699-701.
  15. Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK, vd. The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin. 2017;67(2):93-9.
  16. Kudaş İ, Erdem O, Topçu A, Şişik A. Carcinoid tumor of appendix: Review of consecutive 5131 appendectomy. J Surg Med. 2018;2(2):134-6.
  17. Dean AG, Sullivan KM, Soe MM. OpenEpi: Open Source Epidemiologic Statistics for Public Health, Version. www.OpenEpi. com, updated 2013/04/06, accessed 2024/08/26.
  18. Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 2007;39(2), 175-191.
  19. Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Routledge. https://doi. org/10.4324/9780203771587.
  20. Grozinsky-Glasberg S, Alexandraki KI, Barak D, Doviner V, Reissman P, Kaltsas GA, vd. Current size criteria for the management of neuroendocrine tumors of the appendix: are they valid? Clinical experience and review of the literature. Neuroendocrinology. 2013;98(1):31-7.
  21. Volante M, Daniele L, Asioli S, Cassoni P, Comino A, Coverlizza S, vd. Tumor staging but not grading is associated with adverse clinical outcome in neuroendocrine tumors of the appendix: a retrospective clinical pathologic analysis of 138 cases. Am J Surg Pathol. 2013;37(4):606-12.
  22. In’t Hof KH, van der Wal HC, Kazemier G, Lange JF. Carcinoid tumour of the appendix: an analysis of 1,485 consecutive emergency appendectomies. J Gastrointest Surg Off J Soc Surg Aliment Tract. 2008;12(8):1436-8.
  23. Yilmaz M, Akbulut S, Kutluturk K, Sahin N, Arabaci E, Ara C, vd. Unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis. World J Gastroenterol. 2013;19(25):4015-22.
  24. Roggo A, Wood WC, Ottinger LW. Carcinoid tumors of the appendix. Ann Surg. 1993;217(4):385-90.
  25. Pawa N, Clift AK, Osmani H, Drymousis P, Cichocki A, Flora R, Goldin R, Patsouras D, Baird A, Malczewska A, Kinross J, Faiz O, Antoniou A, Wasan H, Kaltsas GA, Darzi A, Cwikla JB, Frilling A. Surgical Management of Patients with Neuroendocrine Neoplasms of the Appendix: Appendectomy or More. Neuroendocrinology. 2018;106(3):242-251.
  26. Boudreaux JP, Klimstra DS, Hassan MM, Woltering EA, Jensen RT, Goldsmith SJ, vd. The NANETS consensus guideline for the diagnosis and management of neuroendocrine tumors: well-differentiated neuroendocrine tumors of the Jejunum, Ileum, Appendix, and Cecum. Pancreas. 2010;39(6):753-66.
  27. Elkbuli A, Sanchez C, McKenney M, Boneva D. Incidental neuro- endocrine tumor of the appendix: Case report and literature review. Ann Med Surg 2012. 2019;43:44-7.
  28. Maggard MA, O’Connell JB, Ko CY. Updated population-based review of carcinoid tumors. Ann Surg. 2004;240(1):117-22.
  29. Volante M, Grillo F, Massa F, Maletta F, Mastracci L, Campora M, vd. Neuroendocrine neoplasms of the appendix, colon and rectum. Pathologica. 2021;113(1):19-27.
  30. Assarzadegan N, Montgomery E. What is New in the 2019 World Health Organization (WHO) Classification of Tumors of the Digestive System: Review of Selected Updates on Neuroendocrine Neoplasms, Appendiceal Tumors, and Molecular Testing. Arch Pathol Lab Med. 2021;145(6):664-77.
  31. Alexandraki KI, Kaltsas GA, Grozinsky-Glasberg S, Chatzellis E, Grossman AB. Appendiceal neuroendocrine neoplasms: diagnosis and management. Endocr Relat Cancer. 2016;23(1):R27-41.