Erschienen in:
30.07.2023 | Gastrointestinal Oncology
Positive Margin for Low-Grade Appendiceal Mucinous Neoplasms (LAMN): To Observe or to Reoperate?
verfasst von:
Hussein M. Hariri, MD, Sameer H. Patel, MD, FACS
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 12/2023
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Excerpt
Low-grade, appendiceal mucinous neoplasms (LAMNs) are rare and unique tumors of the appendix. Management options can be very broad, ranging from a simple appendectomy to cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) when there is peritoneal spread. Histologically, they are characterized by mucinous epithelium with low-grade cytologic atypia and absence of infiltrative growth, destructive invasion, or associated desmoplastic response.
1,2 These lesions are usually incidentally diagnosed after resection for suspected appendicitis and carry very low recurrence rates when completely resected, having disease confined to the appendix, and in the absence of rupture.
3 In these patients, appendectomy is almost invariably curative and further surgery, such as a right colectomy or ileocecectomy, is not needed.
4 However, some debate surrounds further management of resected LAMNs when there is a “microscopically positive margin” on final pathology. …
