Dergiler / Anatolian Current Medical Journal / 2026 / Volume: 7 Issue: 4

You have missed cancer: the unwanted plot twist of benign surgeries

İsmail Sezikli(HİTİT ÜNİVERSİTESİ)0000-0002-6801-1465
Mahmut Arif Yüksek(HITIT UNIVERSITY, SCHOOL OF MEDICINE)0000-0002-8323-7390
Havva Hande Keser Şahin(HİTİT ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, TIBBİ PATOLOJİ ANABİLİM DALI)0000-0003-1827-1039
Sayfa
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Yayın Tarihi
2025-07-28
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Routine pathological evaluation of all surgical specimens—regardless of presumed benignity—and the implementation of automated alert systems for critical pathology results are essential for timely diagnosis, appropriate referral, and improved patient outcomes.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Aims: Surgical interventions for benign conditions are frequently performed in general surgery practice; however, the incidental detection of malignancies in these specimens represents a clinically significant and often overlooked issue.
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Temel Bulgular & Veri:Methods: A retrospective cohort study was conducted on 2.590 surgical procedures—appendectomy, cholecystectomy, abdominal wall hernia repair, hemorrhoidectomy, and pilonidal sinus excision—performed between January 1, 2023, and January 1, 2024, at a tertiary care institution.
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Sonuç & Katkı:Routine pathological evaluation of all surgical specimens—regardless of presumed benignity—and the implementation of automated alert systems for critical pathology results are essential for timely diagnosis, appropriate referral, and improved patient outcomes.
🔬Tür:Literatür & Derleme Çalışması
📍Kapsam:2023 Verileri
⚙️Değişkenler:Incidental malignancy · surgical pathology · appendectomy

Özet

Aims: Surgical interventions for benign conditions are frequently performed in general surgery practice; however, the incidental detection of malignancies in these specimens represents a clinically significant and often overlooked issue. This study aimed to investigate the incidence, pathological characteristics, and follow-up status of incidental malignancies identified in routinely resected specimens, with a particular emphasis on the adequacy of postoperative notification and follow-up processes. Methods: A retrospective cohort study was conducted on 2.590 surgical procedures—appendectomy, cholecystectomy, abdominal wall hernia repair, hemorrhoidectomy, and pilonidal sinus excision—performed between January 1, 2023, and January 1, 2024, at a tertiary care institution. Patients with preoperatively known or radiologically suspected malignancies were excluded. Pathological reports were reviewed for incidental malignant findings, and follow-up data were obtained via electronic health records and direct patient communication. Results: Among the reviewed cases, ten incidental malignancies (0.39%) were identified: eight in appendectomy specimens, one in a cholecystectomy specimen, and one in a hernia sac. Remarkably, 30% of the affected patients were unaware of their pathological diagnosis until they were contacted by the researchers. Significant variability in specimen submission practices, especially in hernia and hemorrhoidectomy cases, may have contributed to underdiagnosis. Conclusion: Although rare, incidental malignancies carry substantial prognostic implications if left unrecognized or inadequately managed. Routine pathological evaluation of all surgical specimens—regardless of presumed benignity—and the implementation of automated alert systems for critical pathology results are essential for timely diagnosis, appropriate referral, and improved patient outcomes.

Abstract

Aims: Surgical interventions for benign conditions are frequently performed in general surgery practice; however, the incidental detection of malignancies in these specimens represents a clinically significant and often overlooked issue. This study aimed to investigate the incidence, pathological characteristics, and follow-up status of incidental malignancies identified in routinely resected specimens, with a particular emphasis on the adequacy of postoperative notification and follow-up processes. Methods: A retrospective cohort study was conducted on 2.590 surgical procedures—appendectomy, cholecystectomy, abdominal wall hernia repair, hemorrhoidectomy, and pilonidal sinus excision—performed between January 1, 2023, and January 1, 2024, at a tertiary care institution. Patients with preoperatively known or radiologically suspected malignancies were excluded. Pathological reports were reviewed for incidental malignant findings, and follow-up data were obtained via electronic health records and direct patient communication. Results: Among the reviewed cases, ten incidental malignancies (0.39%) were identified: eight in appendectomy specimens, one in a cholecystectomy specimen, and one in a hernia sac. Remarkably, 30% of the affected patients were unaware of their pathological diagnosis until they were contacted by the researchers. Significant variability in specimen submission practices, especially in hernia and hemorrhoidectomy cases, may have contributed to underdiagnosis. Conclusion: Although rare, incidental malignancies carry substantial prognostic implications if left unrecognized or inadequately managed. Routine pathological evaluation of all surgical specimens—regardless of presumed benignity—and the implementation of automated alert systems for critical pathology results are essential for timely diagnosis, appropriate referral, and improved patient outcomes.

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Bu Makaleye Atıf Yap

Sezikli, İ., Yüksek, M. A., Şahin, H. H. K. (2025). You have missed cancer: the unwanted plot twist of benign surgeries. Anatolian Current Medical Journal, Volume: 7 Issue: 4. https://doi.org/10.38053/acmj.1693056

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Kaynakça (18)

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