Mucinous adenocarcinoma of the appendix with histologic response to neoadjuvant chemotherapy: Review of histologic and clinical spectrum of epithelial neoplastic mucinous lesions of the appendix

Mehmet Sitki Copur, Allison M. Cushman-Vokoun, James C. Padussis, Whitney R. Wedel, Caleb W. Schroeder, Daniel J. Herold, Nicholas J. Lintel, Adam J. Horn

Research output: Contribution to journalReview articlepeer-review

Abstract

Appendiceal mucinous neoplasms are a rare and heterogeneous group of diseases with challenging clinical management decisions. They account for less than 1% of all cancers but their incidence is on the rise. Treatment is based on their stage and histology. Appendiceal neoplasms frequently metastasize inside the abdomen; this leads to tumor cell growth in the abdominal cavity, known as peritoneal carcinomatosis, and buildup of mucinous material, known as pseudomyxoma peritonei. While low-grade, early-stage tumors can be effectively treated with limited surgical resection, patients with low-grade, advanced-stage disease require peritoneal debulking and hyperthermic intraperitoneal chemotherapy. Therapeutic options for highgrade, advanced-stage mucinous tumors of the appendix have not been well established. Debulking surgery with hyperthermic intraperitoneal chemotherapy preceded and/or followed by systemic chemotherapy has been utilized based on some prospective but not randomized data. We present a case of mucinous adenocarcinoma of the appendix treated with neoadjuvant chemotherapy followed by cytoreductive surgery/ hyperthermic intraperitoneal chemotherapy and adjuvant chemotherapy. Preoperative chemotherapy provided a favorable histologic response by converting initial mucinous appendiceal adenocarcinoma histology to a high-grade mucinous appendiceal neoplasm.

Original languageEnglish (US)
Pages (from-to)335-340
Number of pages6
JournalONCOLOGY (United States)
Volume35
Issue number6
DOIs
StatePublished - 2021

Keywords

  • Appendiceal epithelial neoplasms
  • Hyperthermic intraperitoneal chemotherapy
  • Peritoneal carcinomatosis

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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