Incidental Finding of Appendiceal Neuroendocrine Tumor during Laparoscopic Exploration for Deep Endometriosis: Case Report
DOI:
https://doi.org/10.32635/2176-9745.RBC.2025v71n3.5128Keywords:
Neuroendocrine Tumors/surgery, Endometriosis, Laparoscopy, AppendectomyAbstract
Introduction: Endometriosis is one of the most prevalent gynecological diseases, affecting 7 to 10% of women at a reproductive age. It consists of endometrial glands and stroma growing outside the uterine cavity, the deepest is the most harmful. Gastrointestinal neuroendocrine tumors are rare, but they are one of the most common neoplasms of the cecal appendix, being more common in women. The objective of this article is to describe a rare case in which, during a videolaparoscopy for deep endometriosis, an incidental appendiceal neuroendocrine tumor was found. Case report: A 44-year-old female patient underwent a videolaparoscopy to control deep endometriosis. It was decided to perform a resection of endometriosis foci associated with appendectomy due to the finding during intestinal exploration. The patient was stable postoperatively with no complications. The anatomopathological examination (cecal appendix) revealed a welldifferentiated neuroendocrine tumor (grade 1), pT1, measuring 0.5 cm in its largest diameter, with free margins, without lymphovascular invasion. Conclusion: This case reinforces the importance of a complete evaluation of the peritoneal cavity, including the appendix, during laparoscopy for patients with endometriosis.
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Dunselman GA, Vermeulen N, Becker C, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014;29(3):400-12 DOI: https://doi.org/10.1093/humrep/det457
Koninckx PR, Ussia A, Adamyan L,. Deep endometriosis: definition, diagnosis, and treatment. Fertil Steril. 2012;98(3):564-71. doi: https://doi.org/10.1016/j.fertnstert.2012.07.1061 DOI: https://doi.org/10.1016/j.fertnstert.2012.07.1061
Moulder JK, Siedhoff MT, Melvin KL, et al. Risk of appendiceal endometriosis among women with deep-infiltrating endometriosis. Int J Gynaecol Obstet. 2017;139(2):149-54 DOI: https://doi.org/10.1002/ijgo.12286
Assarzadegan N, Montgomery E. What is New in 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 Amp Lab Med. 2020;145(6):664-77. doi: https://doi.org/10.5858/arpa.2019-0665-ra DOI: https://doi.org/10.5858/arpa.2019-0665-RA
Morris D, Tsilimigras DI, Vagios S, et al. Neuroendocrine neoplasms of the appendix: a review of the literature. Anticancer Res. 2018;38(2):601-11 DOI: https://doi.org/10.21873/anticanres.12264
Cuthbertson DJ, Shankland R, Srirajaskanthan R. Diagnosis and management of neuroendocrine tumours. Clin Med. 2023;23(2):119-24. doi: https://doi.org/10.7861/clinmed.2023-0044 DOI: https://doi.org/10.7861/clinmed.2023-0044
Nisolle M, Brichant G, Tebache L. Choosing the right technique for deep endometriosis. Best Pract Amp Res Clin Obstet Amp Gynaecol. 2019;59:56-65. doi: https://doi.org/10.1016/j.bpobgyn.2019.01.010 DOI: https://doi.org/10.1016/j.bpobgyn.2019.01.010
Sagae UE, Lopasso F, Abrão MS, et al. Endometriose do trato gastrintestinal: correlações clínicas e laparoscópicas. Rev Bras Coloproctologia. 2007;27(4):423-31 DOI: https://doi.org/10.1590/S0101-98802007000400010
Rosenblum RC, Klein N, Paran H, et al. Appendiceal tumor incidence and an in-depth look at appendiceal neuroendocrine neoplasm in a cohort of 8,162 appendectomies: Full dataset. Data Brief. 2020;33:106456. doi: https://doi.org/10.1016/j.dib.2020.106456 DOI: https://doi.org/10.1016/j.dib.2020.106456
Ellis L, Shale MJ, Coleman MP. Carcinoid tumors of the gastrointestinal tract: trends in incidence in England since 1971. Am J Gastroenterol. 2010;105(12):2563-9 DOI: https://doi.org/10.1038/ajg.2010.341
Süleyman M. Incidental presentation of appendix neuroendocrine tumor: long-term results from a single institution. Turk J Trauma Emerg Surg. 2023:972-7 DOI: https://doi.org/10.14744/tjtes.2023.78038
Altshuler PC, Schultze PM. Diagnosis of appendiceal neuroendocrine tumors following incidental appendectomy during benign gynecologic laparoscopic surgeries: a case series. Cureus. 2023;15(6):e41135. doi: https://doi.org/10.7759/cureus.41135 DOI: https://doi.org/10.7759/cureus.41135
Villaescusa M, Andres MP, Amaral AC, et al. Endometriosis and its relation with carcinoid tumor of the appendix: a systematic review. Minerva Obstet Gynecol. 2021;73(5):606-13 doi: https://doi.org/10.23736/s2724-606x.21.04792-4 DOI: https://doi.org/10.23736/S2724-606X.21.04792-4
Galanopoulos M, Toumpanakis C. The problem of appendiceal carcinoids. Endocrinol Metab Clin North Am. 2018;47(3):661-69 DOI: https://doi.org/10.1016/j.ecl.2018.04.004
Richards-Taylor S, Ewings SM, Jaynes E, et al. The assessment of Ki-67 as a prognostic marker in neuroendocrine tumours: a systematic review and meta-analysis. J Clin Pathol. 2016;69(7):612-8. DOI: https://doi.org/10.1136/jclinpath-2015-203340
Kunz PL, Reidy-Lagunes D, Anthony LB, et al. Consensus guidelines for the management and treatment of neuroendocrine tumors. Pancreas. 2013;42(4):557-77 DOI: https://doi.org/10.1097/MPA.0b013e31828e34a4
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