To summarize current evidence on the incidence, histology, diagnostic limitations, and management implications of appendiceal neoplasms in patients with appendiceal abscess.
Key Findings:
Low incidence of appendiceal neoplasms in uncomplicated appendicitis (<2%).
Higher neoplasm rates (10-15%) in appendicitis complicated by periappendiceal abscess.
Neuroendocrine tumors are more common in uncomplicated cases; low-grade mucinous neoplasms in complicated cases.
Invasive adenocarcinoma is reported, especially in older patients.
Age over 35-40 years significantly increases the risk of underlying neoplasia.
Interpretation:
Appendiceal abscess in adults over 35 years poses a significant risk of neoplasia, necessitating careful preoperative evaluation and consideration for interval appendectomy.
Limitations:
Preoperative imaging has limited accuracy for tumor detection.
The review is narrative and may not encompass all relevant studies.
Conclusion:
Interval appendectomy after successful non-operative management is recommended for adults aged 35 and older with appendiceal abscess to ensure diagnostic certainty and oncologic safety.
