2612 Tumors of the Appendix: Prevalence in Patients with Chronic Pelvic Pain Undergoing Minimally Invasive Excision Surgery with Concomitant Appendectomy for Suspected Endometriosis

Abstract

Study Objective To determine the prevalence of appendiceal tumors in patients with chronic pelvic pain undergoing excisional surgery. Design Retrospective chart review. Setting Two Large Metropolitan Academic Hospitals. Patients or Participants 135 patients between the ages of 16 to 52 with chronic pelvic pain undergoing minimally invasive excision surgery with concomitant appendectomy for suspected endometriosis from January 2012 to June 2017. Interventions Medical records and postoperative pathology reports were analyzed for all 135 patients for the presence of appendiceal tumors, presence of endometriosis, and age. Measurements and Main Results The prevalence of appendiceal tumors in patients with chronic pelvic pain was 3% (95% CI:0.1-5.8%). Of these cases, three were neuroendocrine carcinoid tumors (0.5 cm, 0.6 cm, and 1.1 cm respectively) and one was a low grade appendiceal mucinous neoplasm (LAMN). Two of the patients had biopsy confirmed endometriosis. The biopsy confirmed endometriosis patients had the 0.6 cm neuroendocrine carcinoid tumor and the LAMN, respectively. Patients with and without appendiceal tumors had mean ages of 26.8±7.1 and 32.6±7.6 years, respectively. Conclusion The 3% prevalence of appendiceal tumors in our sample and the young age of the patients with appendiceal tumors is at odds with the much lower prevalence of appendiceal tumors and much older patient population reported in the literature. This highlights the increased need for research to establish predictive diagnostic criteria for appendiceal tumors and suggests that surgeons consider concomitant appendectomies in patients with chronic pelvic pain.