Appendix Cancer
The size of the tumor is directly related to the prognosis . Tumors of the appendix smaller than 2 cm show little tendency to spread and patients usually have an excellent survival at five years, while tumors larger than 2.5 cm may require more intensive treatment and patients have a shorter survival .
Tumors of the appendix can be divided into two main groups:
- Carcinoid tumors
The carcinoid tumors are the most common form, so that account for almost half of all cases of tumors of the appendix. These tumors are more common in women and, in general, appear in the fourth decade of life. About two-thirds of carcinoid tumors are located at the tip of the appendix, where they do not obstruct communication between the appendix and the colon.
In most cases, these tumors are small (less than 2 cm) and have a very low risk of spread to nearby lymph nodes. Appendectomy (removal of the appendix) is the most appropriate treatment in these cases. Large tumors have a somewhat greater risk of metastasizing to surrounding lymph nodes and the liver. Removal of the right colon and regional lymph nodes is recommended.
More than 85% of patients with carcinoid tumors of the appendix (even with regional metastases ) survive after five years.
Most patients do not have symptoms. However, some signs may be:
Acute appendicitis: most cases are discovered during surgery for appendicitis
Carcinoid syndrome (in case of dissemination to the liver): hot flushes, respiratory distress, diarrhea, cardiac valve disease on the right side
- Non-carcinoid tumors
The non-carcinoid tumors of the appendix originate in the epithelial cells that line the interior of the appendix. Most of the cells that cause these tumors produce a gelatinous material called mucin. Given the anatomical structure of the appendix and the production of mucin by these tumors, patients with non-carcinoid tumors of the appendix are at risk of dissemination of tumor cells and mucin inside the abdominal cavity. Without treatment, tumor cells and mucin can accumulate over time and cause a potentially fatal intestinal obstruction and cachexia (weight loss, muscle wasting, loss of appetite and fatigue). The prognosisand the treatment of these tumors depend on several factors related to the patient and the tumor .
The peritoneal pseudomyxoma (SMP) is defined by the presence of acellular mucin (ie, few tumor cells, if any) into the abdominal cavity. The most common presentation of SMP is a mucin-producing tumor of the appendix whose cells have spread beyond it and through the abdominal cavity. The resulting tumor , with an orange gelatin appearance, can weigh 9-13 kg.
There are no specific symptoms of PMS, but some of the most common initial symptoms are:
- Increase in size or perimeter of the abdomen
- Vague abdominal discomfort; persistent discomfort in the lower right portion of the abdomen
- Pelvic discomfort
- New hernias
- Intestinal obstruction
- Ovarian masses
The adenocarcinoides tumors , also called carcinomas of goblet cells, have similar characteristics carcinoid tumors and adenocarcinomas of the appendix. Most cases are diagnosed in the sixth decade of life. The prognosis of these tumors is somewhat worse than that of carcinoid tumors , with a 5-year overall survival of 78%. However, only about 14% of patients with stage IV disease survive more than five years. The main presenting symptom is pain acute abdominal or chronic .
symptom
It is possible that the cancer of appendix does not cause specific symptoms until it evolves to advanced stages. However, abdominal discomfort and swelling sometimes appear with advanced disease.
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