Reta Birhanu Kassie, Gebrecherkos Yordanos Birhane, Gebremichael Yemane Leake, Hagos Hindeya Hailu, Dojamo Demelash Darota, Wubalem Seblewengel Maru
Aksum University, College of Health Science, Department of Pathology, Aksum, Ethiopia.
Aksum University, College of Health Science, School of Medicine, Aksum, Ethiopia.
Int J Surg Case Rep. 2025 Jul;132:111474. doi: 10.1016/j.ijscr.2025.111474. Epub 2025 Jun 3.
Neuroendocrine neoplasms (NENs) of the appendix are rare in children even though they are the second commonest gastrointestinal tumor next to lymphoma. NENs are usually diagnosed incidentally in appendectomies done for appendicitis, occasionally resulting in a second operation to ensure adequacy of the management. This case report is aimed at emphasizing the significance of subjecting any appendectomy specimen to histopathologic examination, irrespective of the indication for appendectomy.
Here we presented a case of a 14-year-old male adolescent who presented with right lower quadrant abdominal pain of 16 h duration. He had leukocytosis with left shift, and the abdominal ultrasound examination concluded acute appendicitis, for which an emergency appendectomy was done. The histopathologic examination of the appendix along with the immunohistochemistry findings for synaptophysin concluded well differentiated neuroendocrine tumor WHO grade 1, AJCC stage PT3NxMx. Subsequent right hemicolectomy with lymphadenectomy was done due to the stage of the tumor.
Appendiceal NENs are extremely uncommon in the global pediatric population and have benign behavior. The tip of the appendix is the commonest site of origin. Surgery is the mainstay of treatment, and size is the most determinant factor in determining the extent of surgery.
Since most appendiceal neuroendocrine tumors are diagnosed incidentally, every appendectomy tissue should be submitted for histopathologic examination to identify the presence of a tumor and determine its stage.
阑尾神经内分泌肿瘤（NENs）在儿童中较为罕见，尽管它是仅次于淋巴瘤的第二常见胃肠道肿瘤。NENs通常在因阑尾炎进行阑尾切除术中偶然被诊断出来，偶尔需要进行二次手术以确保治疗的充分性。本病例报告旨在强调，无论阑尾切除术的指征如何，对任何阑尾切除标本进行组织病理学检查的重要性。
我们在此呈现一名14岁男性青少年的病例，他出现右下腹痛16小时。他白细胞增多且有核左移，腹部超声检查诊断为急性阑尾炎，遂进行了急诊阑尾切除术。阑尾的组织病理学检查以及突触素的免疫组化结果显示为高分化神经内分泌肿瘤，世界卫生组织1级，美国癌症联合委员会分期PT3NxMx。由于肿瘤分期，随后进行了右半结肠切除术及淋巴结清扫术。
阑尾NENs在全球儿科人群中极为罕见，且行为良性。阑尾尖端是最常见的起源部位。手术是主要治疗方法，大小是决定手术范围的最主要因素。
由于大多数阑尾神经内分泌肿瘤是偶然诊断出来的，每个阑尾切除组织都应进行组织病理学检查，以确定肿瘤的存在并确定其分期。
