Yıl: 2021 Cilt: 37 Sayı: 3 Sayfa Aralığı: 303 - 306 Metin Dili: İngilizce DOI: 10.47717/turkjsurg.2021.3877 İndeks Tarihi: 01-06-2022

Coexistence of low-grade mucinous neoplasm and carcinoid (collision tumor) within multiple appendiceal diverticula: a case report

Öz:
Neoplasms of the appendix are very rare. They usually show glandular or neuroendocrine differentiation, and when they both occur in the same area, it is called a “collision tumor.” Low-grade mucinous neoplasms associated with appendiceal diverticula are also uncommon. The appendectomy speci- men of a 60-year-old man contained dense and mucoid luminal content on the distal tip, and similarly a solid, yellow, lumen-obscuring tumor with a diameter of 1.5 cm at the base of the appendix was detected. Microscopically, there were three diverticula that comprised herniation of the mucosal layer through the appendiceal wall. Interestingly, all of the diverticula and the normal-appearing appendiceal wall were lined by adenomatous epithe- lium. The luminal portion had pools of mucin-containing, rare clusters of low-grade epithelium that gave rise to the diagnosis of a“low-grade mucinous neoplasm.” The solid-appearing tumor was diagnosed as a “neuroendocrine neoplasm,” and there was no transition zone between these two types of tumors. There are some cases that have been reported as low-grade mucinous neoplasms associated with appendicular diverticula and collision tumors consisting both mucinous neoplasms and carcinoid tumors in the literature; our case has a unique appearance with two different types of tumors both in the appendix wall and within multiple diverticula
Anahtar Kelime:

Multipl apendiks divertikülünde düşük dereceli müsinöz neoplazm ve karsinoid (kollüz- yon tümör) birlikteliği: bir olgu sunumu

Öz:
Apendiksin neoplazileri oldukça nadirdir. Genellikle glandüler ya da nöroendokrin diferansiyasyon gösterirler ve aynı alanda bir arada oldukla- rında “kollüzyon tümör” olarak adlandırılırlar. Apendiks düvertikülüyle birlikte olan düşük dereceli müsinöz neoplazmlar de oldukça nadirdir. 60 yaşında erkek hastanın appendektomi materyalinde kistik olarak dilatasyona uğramış distal kısımda yoğun, mukoid lümen içeriği izlendi. Benzer şekilde apendiks tabanında 1,5 cm çapında lümeni tıkayan solid, sarı-beyaz bir tümör görüldü. Mikroskopik olarak her biri apendisyel duvara mu- kozal tabakanın herniasyonuyla karakterli 3 adet divertikül izlendi. İlginç olarak, tüm divertiküller ve normal görünen apendiks duvarı adenama- töz epitelle döşeliydi. Lümende nadir düşük dereceli epitel fragmanları taşıyan müsin gölcüklerinin varlığı ile “düşük dereceli müsinöz neoplazm” tanısı kondu. Solid görünen tümör ise nöroendokrin neoplazi olarak değerlendirildi ve bu iki tip tümör arasında geçiş zonu izlenmedi. Literatürde apendiks divertikülüyle ilişkili düşük dereceli müsinöz neoplazm ve karsinoid tümörden oluşan kollüzyon tümörler bildirilmiştir ve bizim olgumuz hem apendiks duvarında hem de multipl divertikül içinde iki ayrı tümörün varlığı ile son derece ilginç bir birliktelik göstermektedir
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Erişime Açık
  • 1. Chandrasegaram MD, Rothwell LA, An EI, Miller RJ. Pathologies of the appendix: a 10-year review of 4670 appendicectomy specimens. ANZ J Surg 2012 Nov; 82(11): 844-7. [CrossRef]
  • 2. Lamps LW, Gray GF Jr, Dilday BR, Washington MK. The coexistence of low-grade mucinous neoplasms of the appendix and appendiceal diverticula: a possible role in the pathogenesis of pseudomyxoma peritonei. Mod Pathol 2000 May; 13(5): 495-501. [CrossRef]
  • 3. Singh NG, Mannan AASR, Kahvic M, Nur AM. Mixed adenocarcino- ma-carcinoid (collision tumor) of the appendix. Med Princ Pract 2011; 20: 384-6. [CrossRef]
  • 4. Bronzino P, Abbo L, Bagnasco F, Barisone P, Dezzani C, Genovese AM, et al. Appendiceal mucocele due to mucinous cystadenoma: case report and review of the literature. G Chir 2006 Mar; 27(3): 97-9. [CrossRef]
  • 5. Yilmaz M, Akbulut S, Kutluturk K, Sahin N, Arabaci E, Ara C, et al. Un- usual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis. World J Gastroenter- ol 2013; 19(25): 4015-22. [CrossRef]
  • 6. Al-Talib RK, Mason CH, Theaker JM. Combined goblet cell carcinoid and mucinous cystadenoma of the appendix. I Clin Pathol 1995; 48: 869-70. [CrossRef]
  • 7. Dupre MP, Jadavji I, Matshes E, Urbanski SJ. Diverticular disease of the vermiform appendix: a diagnostic clue to underlying appendiceal neoplasm. Hum Pathol 2008 Dec; 39(12): 1823-6. [CrossRef]
  • 8. Ramaswamy V. Pathology of mucinous appendiceal tumors and pseudomyxoma peritonei. Indian J Surg Oncol 2016 Jun; 7(2): 258-67. [CrossRef]
  • 9. Fukui H, Takada M, Chiba T, Kashiwagi R, Sakane M, Tabata F, et al. Concurrent occurrence of gastric adenocarcinoma and duodenal neuroendocrine cell carcinoma: a composite tumour or collision tu- mours? Gut 2001 Jun; 48(6): 853-6. [CrossRef]
  • 10. Dellaportas D, Vlahos N, Polymeneas G, Gkiokas G, Dastamani C, Carvounis E, et al. Collision tumor of the appendix: mucinous cystad- enoma and carcinoid. A case report. Chirurgia (Bucur) 2014 Nov-Dec; 109(6): 843-5. [CrossRef]
  • 11. Fornaro R, Frascio M, Sticchi C, De Salvo L, Stabilini C, Mandolfino F, et al. Appendectomy or right hemicolectomy in the treatment of appendiceal carcinoid tumors? Tumori 2007 Nov-Dec; 93(6): 587-90. [CrossRef]
  • 12. Kehagias I, Zygomalas A, Markopoulos G, Papandreou T, Kraniotis P. Diagnosis and treatment of mucinous appendiceal neoplasm pre- sented as acute appendicitis. Case Rep Oncol Med 2016; 2161952. [CrossRef]
APA Ekinci N, GUN E, Avci A, Er A (2021). Coexistence of low-grade mucinous neoplasm and carcinoid (collision tumor) within multiple appendiceal diverticula: a case report. , 303 - 306. 10.47717/turkjsurg.2021.3877
Chicago Ekinci Nese,GUN Eylul,Avci Arzu,Er Ahmet Coexistence of low-grade mucinous neoplasm and carcinoid (collision tumor) within multiple appendiceal diverticula: a case report. (2021): 303 - 306. 10.47717/turkjsurg.2021.3877
MLA Ekinci Nese,GUN Eylul,Avci Arzu,Er Ahmet Coexistence of low-grade mucinous neoplasm and carcinoid (collision tumor) within multiple appendiceal diverticula: a case report. , 2021, ss.303 - 306. 10.47717/turkjsurg.2021.3877
AMA Ekinci N,GUN E,Avci A,Er A Coexistence of low-grade mucinous neoplasm and carcinoid (collision tumor) within multiple appendiceal diverticula: a case report. . 2021; 303 - 306. 10.47717/turkjsurg.2021.3877
Vancouver Ekinci N,GUN E,Avci A,Er A Coexistence of low-grade mucinous neoplasm and carcinoid (collision tumor) within multiple appendiceal diverticula: a case report. . 2021; 303 - 306. 10.47717/turkjsurg.2021.3877
IEEE Ekinci N,GUN E,Avci A,Er A "Coexistence of low-grade mucinous neoplasm and carcinoid (collision tumor) within multiple appendiceal diverticula: a case report." , ss.303 - 306, 2021. 10.47717/turkjsurg.2021.3877
ISNAD Ekinci, Nese vd. "Coexistence of low-grade mucinous neoplasm and carcinoid (collision tumor) within multiple appendiceal diverticula: a case report". (2021), 303-306. https://doi.org/10.47717/turkjsurg.2021.3877
APA Ekinci N, GUN E, Avci A, Er A (2021). Coexistence of low-grade mucinous neoplasm and carcinoid (collision tumor) within multiple appendiceal diverticula: a case report. Turkish Journal of Surgery, 37(3), 303 - 306. 10.47717/turkjsurg.2021.3877
Chicago Ekinci Nese,GUN Eylul,Avci Arzu,Er Ahmet Coexistence of low-grade mucinous neoplasm and carcinoid (collision tumor) within multiple appendiceal diverticula: a case report. Turkish Journal of Surgery 37, no.3 (2021): 303 - 306. 10.47717/turkjsurg.2021.3877
MLA Ekinci Nese,GUN Eylul,Avci Arzu,Er Ahmet Coexistence of low-grade mucinous neoplasm and carcinoid (collision tumor) within multiple appendiceal diverticula: a case report. Turkish Journal of Surgery, vol.37, no.3, 2021, ss.303 - 306. 10.47717/turkjsurg.2021.3877
AMA Ekinci N,GUN E,Avci A,Er A Coexistence of low-grade mucinous neoplasm and carcinoid (collision tumor) within multiple appendiceal diverticula: a case report. Turkish Journal of Surgery. 2021; 37(3): 303 - 306. 10.47717/turkjsurg.2021.3877
Vancouver Ekinci N,GUN E,Avci A,Er A Coexistence of low-grade mucinous neoplasm and carcinoid (collision tumor) within multiple appendiceal diverticula: a case report. Turkish Journal of Surgery. 2021; 37(3): 303 - 306. 10.47717/turkjsurg.2021.3877
IEEE Ekinci N,GUN E,Avci A,Er A "Coexistence of low-grade mucinous neoplasm and carcinoid (collision tumor) within multiple appendiceal diverticula: a case report." Turkish Journal of Surgery, 37, ss.303 - 306, 2021. 10.47717/turkjsurg.2021.3877
ISNAD Ekinci, Nese vd. "Coexistence of low-grade mucinous neoplasm and carcinoid (collision tumor) within multiple appendiceal diverticula: a case report". Turkish Journal of Surgery 37/3 (2021), 303-306. https://doi.org/10.47717/turkjsurg.2021.3877