Incidental Appendiceal Neuroendocrine Tumors (NETs): A Case Report and Review Of Literature
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Abstract
Incidental appendiceal neuroendocrine tumors (NETs) are rare and mostly asymptomatic or come with clinically suspected appendicitis. Although, there is a various review of literatures and consensus guidelines, there has been controversy in the management of tumor size 1-2 cm or grading G2 – G3 according to mitotic count (mitoses/10 HPF) or Ki-67. A 20-year-old female presented to the emergency department with acute right lower quadrant abdominal pain with an onset of 2 hours. The presumed clinical diagnosis was acute appendicitis. She underwent an open appendectomy and the histopathologic result of the specimen showed a neuroendocrine tumor of the appendix. It was a controversial decision since it was a well-differentiated tumor of <1 cm as well as G2 at the distal half of the appendix, which made it a challenging surgery. The patient was informed and computer tomography (CT) scan and colonoscopy was done for further evaluation. Discussion of whether a right-hemicolectomy or single appendectomy was proposed to the patient, finally a right hemicolectomy was performed. However, more studies should be conducted to determine the optimal management and follow-up strategy for situations like this.
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