Neuroendocrine tumor in clinically diagnosed acute appendicitis

Background: Neuroendocrine tumors of appendix are rare and are mostly detected incidentally in appendectomy specimen removed for acute appendicitis. Aim: To report our experience of incidentally detected neuroendocrine tumors (NETs) of appendix primarily removed with the clinical presentation of acute appendicitis at our teaching hospital. Methods: The study was a two year retrospective study, done in the Department of Pathology, Government Medical College, Baramulla, Jammu and Kashmir, India. A total of 601 appendix specimens were examined. The data regarding age, gender, clinical-presentation, pre-operative radiological investigation and demography was collected. All cases were examined by two independent pathologists. Results: Out of 601 appendectomy specimens received in our department from September 2022 to September 2024, 15 (2.40%) showed histopathological features of well differentiated neuroendocrine tumor (carcinoid). Mean age at presentation was 23.72 years. The male to female ratio was 1:2. Tip was the most common location. The largest tumor diameter in our study was 2.2cm. One of the appendix had a synchronous Neuroendocrine Tumor and an epithelial- Low grade Mucinous Neoplasm. Conclusion: Appendiceal NET tumors most often present as appendicitis. Most of the cases are found incidentally during routine HPE and its diagnosis is rarely suspected pre-operatively, emphasizing the routine HPE of all appendectomy specimens. Ours is the first study that emphasizes this rare condition from our region so far.