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abstract/open access (pdf)
Outcome of Appendicectomies at Surgery for Mucinous Ovarian Neoplasms: Report From A UK Center and Review of Literature
Objective: This study aimed to determine the frequency of
malignant pathology in a macroscopically normal appendix during surgery
for a borderline or malignant mucinous ovarian tumor (MOT).
Methods: Women with borderline and malignant MOT were
identified from the pathology database from 2000 to 2014. Women who had a
benign MOT and had an appendicectomy were excluded from the study. Data
were collected from the electronic patient record and case notes.
Results: Of 310 women identified with MOT, 203 patients
with benign MOT were excluded. Of the remaining 107 patients, 15
patients with previous appendicectomy were also excluded. The study
population consisted of 92 patients. There were 57 (62%) patients with
borderline MOT and 35 (38%) patients with malignant MOT. In the
borderline subgroup, 40/57 (70%) patients had appendicectomy of whom 8
(20%) had macroscopically abnormal appendices. One patient had pseudomyxoma peritonei secondarily involving the appendix and 7 patients
had a histologically normal appendix. Normal histology was found in all
macroscopically normal appendices. In the malignant subgroup, 29/35
(83%) patients had an appendicectomy. There were 8 (27.5%)
macroscopically abnormal appendices with a malignant pathology in 7
(87.5%) patients and 1 patient had a resolving appendicitis. There were
21 macroscopically normal appendices of which, serrated adenoma was
found in 1 (4.8%) patient, whereas the remaining 20 (95.2%) patients had
normal histology.
Conclusions: In MOT, an abnormal appearing appendix
should be excised. If the appendix is grossly normal, our data do not
support performing an appendicectomy as part of a surgical staging
procedure.
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