The Frontiers of Appendiceal Controversies: Mucinous Neoplasms and Pseudomyxoma Peritonei.
Journal
The American journal of surgical pathology
ISSN: 1532-0979
Titre abrégé: Am J Surg Pathol
Pays: United States
ID NLM: 7707904
Informations de publication
Date de publication:
01 01 2022
01 01 2022
Historique:
pubmed:
9
1
2021
medline:
15
2
2022
entrez:
8
1
2021
Statut:
ppublish
Résumé
Appendiceal mucinous neoplasms show a range of morphologic features and biological risk. At one end of the spectrum, high-grade adenocarcinomas are cytologically malignant with infiltrative invasion, lymph node metastases, and behavior similar to that of extra-appendiceal mucinous adenocarcinomas. At the other end, mucinous neoplasms confined to the mucosa are uniformly benign. Some cases lying between these extremes have potential risk to metastasize within the abdomen despite a lack of malignant histologic features. They show "diverticulum-like," pushing invasion of mostly low-grade epithelium through the appendix with, or without, concomitant organizing intra-abdominal mucin. The latter condition, widely termed "pseudomyxoma peritonei," tends to pursue a relentless course punctuated by multiple recurrences despite cytoreductive therapy, culminating in death for many patients. The combination of bland histologic features and protracted behavior of peritoneal disease has led some authors to question whether these metastatic tumors even represent malignancies. The World Health Organization and its cadre of experts widely promote usage of "low-grade appendiceal mucinous neoplasm" as an umbrella term to encompass benign and malignant conditions, as well as those that have uncertain biological potential. Although this practice greatly simplifies tumor classification, it causes confusion and consternation among pathologists, clinical colleagues, and patients. It also increases the likelihood that at least some patients will undergo unnecessary surveillance for, and treatment of, benign neoplasms and non-neoplastic conditions. The purpose of this review is to critically evaluate the relevant literature and discuss a practical approach to classifying appendiceal mucinous neoplasms that more closely approximates their biological risk.
Identifiants
pubmed: 33417324
doi: 10.1097/PAS.0000000000001662
pii: 00000478-202201000-00003
doi:
Substances chimiques
Biomarkers, Tumor
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e27-e42Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.
Références
Lamps LW, Gray GF Jr, Dilday BR, et al. The coexistence of low-grade mucinous neoplasms of the appendix and appendiceal diverticula: a possible role in the pathogenesis of pseudomyxoma peritonei. Mod Pathol. 2000;13:495–501.
Misdraji J, Yantiss RK, Graeme-Cook FM, et al. Appendiceal mucinous neoplasms: a clinicopathologic analysis of 107 cases. Am J Surg Pathol. 2003;27:1089–1103.
Pai RK, Beck AH, Norton JA, et al. Appendiceal mucinous neoplasms: clinicopathologic study of 116 cases with analysis of factors predicting recurrence. Am J Surg Pathol. 2009;33:1425–1439.
Carr NJ, Bibeau F, Bradley RF, et al. The histopathological classification, diagnosis and differential diagnosis of mucinous appendiceal neoplasms, appendiceal adenocarcinomas and pseudomyxoma peritonei. Histopathology. 2017;71:847–858.
Ronnett BM, Zahn CM, Kurman RJ, et al. Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis. A clinicopathologic analysis of 109 cases with emphasis on distinguishing pathologic features, site of origin, prognosis, and relationship to “pseudomyxoma peritonei”. Am J Surg Pathol. 1995;19:1390–1408.
Vang R, Gown AM, Zhao C, et al. Ovarian mucinous tumors associated with mature cystic teratomas: morphologic and immunohistochemical analysis identifies a subset of potential teratomatous origin that shares features of lower gastrointestinal tract mucinous tumors more commonly encountered as secondary tumors in the ovary. Am J Surg Pathol. 2007;31:854–869.
Szych C, Staebler A, Connolly DC, et al. Molecular genetic evidence supporting the clonality and appendiceal origin of pseudomyxoma peritonei in women. Am J Pathol. 1999;154:1849–1855.
Bradley RF, Stewart JHt, Russell GB, et al. Pseudomyxoma peritonei of appendiceal origin: a clinicopathologic analysis of 101 patients uniformly treated at a single institution, with literature review. Am J Surg Pathol. 2006;30:551–559.
Carr NJ, Cecil TD, Mohamed F, et al. A consensus for classification and pathologic reporting of pseudomyxoma peritonei and associated appendiceal neoplasia: the results of the Peritoneal Surface Oncology Group International (PSOGI) Modified Delphi Process. Am J Surg Pathol. 2016;40:14–26.
Overman MJ, Asare EA, Compton CC, et al. Amin MB, Edge SB, Greeme FL, Byrd DR, Brookland RK, Washington MK, et al. Appendix: carcinoma. AJCC Cancer Staging Manual, 8th ed. New York, NY: Springer; 2017:237–250.
Carr NJ, Finch J, Ilesley IC, et al. Pathology and prognosis in pseudomyxoma peritonei: a review of 274 cases. J Clin Pathol. 2012;65:919–923.
Miner TJ, Shia J, Jaques DP, et al. Long-term survival following treatment of pseudomyxoma peritonei: an analysis of surgical therapy. Ann Surg. 2005;241:300–308.
Al-Azzawi M, Misdraji J, van Velthuysen MF, et al. Acellular mucin in pseudomyxoma peritonei of appendiceal origin: what is adequate sampling for histopathology? J Clin Pathol. 2020;73:220–222.
Narasimhan V, Wilson K, Britto M, et al. Outcomes following cytoreduction and HIPEC for pseudomyxoma peritonei: 10-year experience. J Gastrointest Surg. 2020;24:899–906.
Misdraji J, Carr NJ, Pai RK Nagtegaal ID, Klimstra DS, Washington MK. Tumours of the appendix: appendiceal mucinous neoplasm. Digestive System Tumours: WHO Classification of Tumours, 5th ed. Lyon, France: International Agency for Research on Cancer; 2019:143–146.
Shetty S, Natarajan B, Thomas P, et al. Proposed classification of pseudomyxoma peritonei: influence of signet ring cells on survival. Am Surg. 2013;79:1171–1176.
Davison JM, Choudry HA, Pingpank JF, et al. Clinicopathologic and molecular analysis of disseminated appendiceal mucinous neoplasms: identification of factors predicting survival and proposed criteria for a three-tiered assessment of tumor grade. Mod Pathol. 2014;27:1521–1539.
van den Heuvel MG, Lemmens VE, Verhoeven RH, et al. The incidence of mucinous appendiceal malignancies: a population-based study. Int J Colorectal Dis. 2013;28:1307–1310.
Lowes H, Rowaiye B, Carr NJ, et al. Complicated appendiceal diverticulosis versus low-grade appendiceal mucinous neoplasms: a major diagnostic dilemma. Histopathology. 2019;75:478–485.
Hissong E, Goncharuk T, Song W, et al. Post-inflammatory mucosal hyperplasia and appendiceal diverticula simulate features of low-grade appendiceal mucinous neoplasms. Mod Pathol. 2020;33:953–961.
Gundogar O, Kimiloglu E, Komut N, et al. Evaluation of appendiceal mucinous neoplasms with a new classification system and literature review. Turk J Gastroenterol. 2018;29:533–542.
Liao X, Vavinskaya V, Sun K, et al. Mutation profile of high-grade appendiceal mucinous neoplasm. Histopathology. 2020;76:461–469.
Valasek MA, Thung I, Gollapalle E, et al. Overinterpretation is common in pathological diagnosis of appendix cancer during patient referral for oncologic care. PLoS One. 2017;12:e0179216.
Hsu M, Young RH, Misdraji J. Ruptured appendiceal diverticula mimicking low-grade appendiceal mucinous neoplasms. Am J Surg Pathol. 2009;33:1515–1521.
Misdraji J, Lauwers GY, Irving JA, et al. Appendiceal or cecal endometriosis with intestinal metaplasia: a potential mimic of appendiceal mucinous neoplasms. Am J Surg Pathol. 2014;38:698–705.
Shaheen NJ, Dulai GS, Ascher B, et al. Effect of a new diagnosis of Barrett’s esophagus on insurance status. Am J Gastroenterol. 2005;100:577–580.
Arnason T, Kamionek M, Yang M, et al. Significance of proximal margin involvement in low-grade appendiceal mucinous neoplasms. Arch Pathol Lab Med. 2015;139:518–521.
Yantiss RK, Shia J, Klimstra DS, et al. Prognostic significance of localized extra-appendiceal mucin deposition in appendiceal mucinous neoplasms. Am J Surg Pathol. 2009;33:248–255.
Oliak D, Yamini D, Udani VM, et al. Initial nonoperative management for periappendiceal abscess. Dis Colon Rectum. 2001;44:936–941.
Simillis C, Symeonides P, Shorthouse AJ, et al. A meta-analysis comparing conservative treatment versus acute appendectomy for complicated appendicitis (abscess or phlegmon). Surgery. 2010;147:818–829.
Mentula P, Sammalkorpi H, Leppaniemi A. Laparoscopic surgery or conservative treatment for appendiceal abscess in adults? A randomized controlled trial. Ann Surg. 2015;262:237–242.
Lai HW, Loong CC, Chiu JH, et al. Interval appendectomy after conservative treatment of an appendiceal mass. World J Surg. 2006;30:352–357.
Carpenter SG, Chapital AB, Merritt MV, et al. Increased risk of neoplasm in appendicitis treated with interval appendectomy: single-institution experience and literature review. Am Surg. 2012;78:339–343.
Lu P, McCarty JC, Fields AC, et al. Risk of appendiceal cancer in patients undergoing appendectomy for appendicitis in the era of increasing nonoperative management. J Surg Oncol. 2019;120:452–459.
Furman MJ, Cahan M, Cohen P, et al. Increased risk of mucinous neoplasm of the appendix in adults undergoing interval appendectomy. JAMA Surg. 2013;148:703–706.
Stockl T, Ross JS, Walter O, et al. Appendiceal mucosal Schwann cell proliferation: a putative histologic marker of appendiceal diverticular disease. Int J Surg Pathol. 2013;21:603–609.
Yantiss RK, Clement PB, Young RH. Endometriosis of the intestinal tract: a study of 44 cases of a disease that may cause diverse challenges in clinical and pathologic evaluation. Am J Surg Pathol. 2001;25:445–454.
Jevon GP, Daya D, Qizilbash AH. Intussusception of the appendix. A report of four cases and review of the literature. Arch Pathol Lab Med. 1992;116:960–964.
Maltz C, Sonoda T, Yantiss RK. Endometriosis causing ileocecal intussusception. Gastrointest Endosc. 2008;67:352–353.
Kim J, Russell P, Arendse M, et al. Endometriosis in appendix and adjacent caecum with intestinal gland differentiation. Pathology. 2013;45:513–516.
Vyas M, Wong S, Zhang X. Intestinal metaplasia of appendiceal endometriosis is not uncommon and may mimic appendiceal mucinous neoplasm. Pathol Res Pract. 2017;213:39–44.
Nakatani Y, Hara M, Misugi K, et al. Appendiceal endometriosis in pregnancy. Report of a case with perforation and review of the literature. Acta Pathol Jpn. 1987;37:1685–1690.
Suster S, Moran CA. Deciduosis of the appendix. Am J Gastroenterol. 1990;85:841–845.
Bettington M, Brown IS, Rosty C. Serrated lesions of the appendix in serrated polyposis patients. Pathology. 2016;48:30–34.
Yantiss RK, Panczykowski A, Misdraji J, et al. A comprehensive study of nondysplastic and dysplastic serrated polyps of the vermiform appendix. Am J Surg Pathol. 2007;31:1742–1753.