Pediatric tectal plate gliomas: clinical and radiological progression, MR imaging characteristics, and management of hydrocephalus

Object Tectal plate gliomas are generally low-grade astrocytomas with favorable prognosis, and observation of the lesion and management of hydrocephalus remain the mainstay of treatment. Methods A cohort of patients with tectal plate gliomas at 2 academic institutions was retrospectively reviewed. Results Forty-four patients with a mean age of 10.2 years who harbored tectal plate gliomas were included in the study. The mean clinical and radiological follow-up was 7.6 ± 3.3 years (median 7.9 years, range 1.5–14.7 years) and 6.5 ± 3.1 years (median 6.5 years, range 1.1–14.7 years), respectively. The most frequent intervention was CSF diversion (81.8% of patients) followed by biopsy (11.4%), radiotherapy (4.5%), chemotherapy (4.5%), and resection (2.3%). On MR imaging tectal plate gliomas most commonly showed T1-weighted isointensity (71.4%), T2-weighted hyperintensity (88.1%), and rarely enhanced (19%). The initial mean volume was 1.6 ± 2.2 cm3 and it increased to 2.0 ± 4.4 cm3 (p = 0.628) at the last follow-up. Frontal and occipital horn ratio (FOHR) and third ventricular width statistically decreased over time (p < 0.001 and p < 0.05, respectively). Conclusions The authors' results support existing evidence that tectal plate gliomas frequently follow a benign clinical and radiographic course and rarely require any intervention beyond management of associated hydrocephalus.

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The natural history of pineal cysts in children and young adults

Journal of Neurosurgery Pediatrics ◽

10.3171/2009.9.peds09297 ◽

2010 ◽

Vol 5 (2) ◽

pp. 162-166 ◽

Cited By ~ 45

Author(s):

Wajd N. Al-Holou ◽

Cormac O. Maher ◽

Karin M. Muraszko ◽

Hugh J. L. Garton

Keyword(s):

Natural History ◽

Mr Imaging ◽

Initial Study ◽

Older Children ◽

Imaging Evaluation ◽

Imaging Appearance ◽

Imaging Characteristics ◽

History Of ◽

The Mean

Object The authors reviewed their experience with pediatric pineal cysts to define the natural history and clinical relevance of this common intracranial finding. Methods The authors identified all patients with pineal cysts who had been clinically evaluated at their institution over an 11.5-year interval and were < 25 years of age at the time of diagnosis. All inclusion criteria were met in 106 patients, and included repeated MR imaging as well as repeated clinical evaluation over at least a 6-month interval. Results The mean age at diagnosis was 11.7 ± 7.2 years. Forty-two patients were male and 64 were female. On follow-up MR imaging evaluation at a mean interval of 3.0 years from the initial study, 98 pineal cysts had no increase in size and no change in imaging appearance. Six pineal cysts increased in size and 2 others had a change in imaging characteristics without associated growth. Younger age was associated with cyst change or growth on follow-up imaging (p = 0.02). The mean age of patients with cysts that changed or grew was 5.5 years, and the mean age of patients with stable pineal cysts was 12.2 years. Initial cyst size and appearance on MR imaging were not significant predictors of growth or change in imaging appearance at follow-up. Similarly, the patient's sex was not a significant predictor of growth or change in imaging characteristics. Conclusions Follow-up imaging and neurosurgical evaluation may be considered optional in older children with pineal cysts.

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Benign intrinsic tectal “tumors” in children

Journal of Neurosurgery ◽

10.3171/jns.1991.74.6.0867 ◽

1991 ◽

Vol 74 (6) ◽

pp. 867-871 ◽

Cited By ~ 71

Author(s):

Paul L. May ◽

Susan I. Blaser ◽

Harold J. Hoffman ◽

Robin P. Humphreys ◽

Derek C. Harwood-Nash

Keyword(s):

Mr Imaging ◽

Intellectual Development ◽

Content Type ◽

Radiological Features ◽

Cystic Component ◽

Tectal Plate ◽

Midbrain Tumors ◽

Csf Diversion ◽

Serial Examination

✓ A specific group of intrinsic dorsal midbrain tumors was identified in six children by computerized tomography (CT) and magnetic resonance (MR) imaging. Each patient presented with raised intracranial pressure as a result of hydrocephalus due to obstruction of the sylvian aqueduct. No patient had brain-stem signs referable to the tectal tumor initially or subsequently. All six children underwent cerebrospinal fluid (CSF) diversionary procedures. The radiological features were consistent and specific, with all patients showing tectal calcification or primary increased attenuation of the tectal plate on CT scans. In addition, lack of contrast enhancement was noted initially in four patients and eventually in all six patients. In all patients MR imaging showed a focal tectal tumor distorting the colicular plate with no cystic component and increased signal intensity on T2-weighted images. There has been no evidence of progression in these six patients in the follow-up period ranging from 8 months to 17 years (8 months and 2½, 4½, 5½, 8, and 17 years). Diversion of CSF has been the only surgical treatment and no patient underwent deep x-ray therapy. Five patients have had normal intellectual development. In contrast to the majority of previously described periaqueductal and tectal tumors, this group of lesions appeared to be truly benign. The authors suggest that patients presenting with these clinical and radiological features may be managed by CSF diversion, serial examination, and MR imaging.

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Long-term change in ventricular size following endoscopic third ventriculostomy for hydrocephalus due to tectal plate gliomas

Journal of Neurosurgery Pediatrics ◽

10.3171/2012.9.peds12243 ◽

2013 ◽

Vol 11 (1) ◽

pp. 20-25 ◽

Cited By ~ 12

Author(s):

Andrew Romeo ◽

Robert P. Naftel ◽

Christoph J. Griessenauer ◽

Gavin T. Reed ◽

Richard Martin ◽

...

Keyword(s):

Endoscopic Third Ventriculostomy ◽

Third Ventriculostomy ◽

Ventricular Size ◽

Size Change ◽

Term Change ◽

Tectal Plate ◽

Additional Procedure ◽

Csf Diversion ◽

The Mean

Object Endoscopic third ventriculostomy (ETV) is an alternative to shunt placement in children with hydrocephalus due to tectal plate gliomas (TPGs). However, controversy remains regarding the amount of ventricular size reduction that should be expected after ETV. This study investigates ventricular size change after ETV for TPGs. Methods Twenty-two children were identified from a 15-year retrospective database of neuroendoscopic procedures performed at the authors' institution, Children's Hospital of Alabama, in patients with a minimum of 1 year of follow-up. Clinical outcomes, including the need for further CSF diversion and symptom resolution, were recorded. The frontal and occipital horn ratio (FOR) was measured on pre- and postoperative, 1-year, and last follow-up imaging studies. Results In 17 (77%) of 22 children no additional procedure for CSF diversion was required. Of those in whom CSF diversion failed, 4 underwent successful repeat ETV and 1 required shunt replacement. Therefore, in 21 (96%) of 22 patients, CSF diversion was accomplished with ETV. Preoperative and postoperative imaging was available for 18 (82%) of 22 patients. The FOR decreased in 89% of children who underwent ETV. The FOR progressively decreased 1.7%, 11.2%, and 12.7% on the initial postoperative, 1-year, and last follow-up images, respectively. The mean radiological follow-up duration for 18 patients was 5.4 years. When ETV failed, the FOR increased at the time of failure in all patients. Failure occurred 1.6 years after initial ETV on average. The mean clinical follow-up period for all 22 patients was 5.3 years. In all cases clinical improvement was demonstrated at the last follow-up. Conclusions Endoscopic third ventriculostomy successfully treated hydrocephalus in the extended follow-up period of patients with TPGs. The most significant reduction in ventricular size was observed at the the 1-year followup, with only modest reduction thereafter.

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Long-Term Outcomes of Patients with Hydrocephalus Secondary to Tectal Plate Glioma versus Idiopathic Aqueductal Stenosis: Results from a Single Center

Pediatric Neurosurgery ◽

10.1159/000515516 ◽

2021 ◽

pp. 1-11

Author(s):

Hamid Reza Niknejad ◽

Melissa Frederickx ◽

Emiel Salaets ◽

Jurgen Lemiere ◽

Lieven Lagae ◽

...

Keyword(s):

Aqueductal Stenosis ◽

Maximum Diameter ◽

Benign Tumors ◽

Term Outcome ◽

Adequate Treatment ◽

Long Term Outcome ◽

Tectal Plate ◽

The Mean

Introduction: Tectal plate gliomas (TPG) constitute a distinct entity of benign tumors of the brain stem which show an indolent clinical course. Adequate treatment of secondary hydrocephalus is undoubtedly a major factor in the outcome. However, little is known about to what degree the tumor itself determines the long-term outcome of these patients. Methods: We retrospectively analyzed and compared the clinical and radiological data of 16 pediatric TPG patients with data of 12 pediatric idiopathic aqueductal stenosis (IAS) patients treated in our center from 1988 to 2018. For both groups, we assessed the long-term outcome in terms of hydrocephalus management, and for the TPG group, we assessed tumor growth during follow-up. In a separate prospective part of the study, we performed a neuropsychological evaluation in a subgroup of patients using a standardized testing battery, covering intelligence, learning, memory, executive functions, and an inventory on depression. Results: In the TPG group, the mean clinical and radiological follow-up was 84 and 70 months, respectively. On average, the maximum diameter of the tumor increased by 11% (p = 0.031) and the estimated tumor volume with 35% (p = 0.026) on radiological follow-up. The fronto-occipital horn ratio (FOHR) decreased by 23% on average after treatment. In the IAS group, the mean clinical and radiological follow-up was 117 and 85 months, respectively. In this group, the FOHR decreased by 21% on average. Neurocognitive testing revealed significant higher scores in the TPG group on global intelligence (TPG = 109, IAS = 85.5, U = 3, p < 0.01, z = −2.71), performance (TPG= 100, IAS = 85, U = 7, p = 0.03, z = −2.2), and verbal intelligence (TPG = 122, IAS = 91.5, U = 2, p < 0.00, z = −2.87) as well as working memory (TPG = 109.5, IAS = 77, U = 0.5, p = 0.01, z = −2.46). Conclusion: Our results suggest that the long-term outcome in TPG patients is acceptable and that cognition is substantially better preserved than in patients with IAS. This puts the idea of a significant contribution of the tumoral mass to disease outcome on the long term in question. Adequate and prompt management of hydrocephalus is the most important factor in long-term cognitive outcome.

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Endoscopic Mucosal Resection: Early Experience in British Columbia

Canadian Journal of Gastroenterology ◽

10.1155/2010/897473 ◽

2010 ◽

Vol 24 (4) ◽

pp. 239-244 ◽

Cited By ~ 6

Author(s):

Mayur Brahmania ◽

Eric Lam ◽

Jennifer Telford ◽

Robert Enns

Keyword(s):

British Columbia ◽

Barrett’S Esophagus ◽

Endoscopic Mucosal Resection ◽

Barrett's Esophagus ◽

Low Grade ◽

Complication Rates ◽

The Third ◽

Mucosal Resection ◽

The Mean

BACKGROUND: Endoscopic mucosal resection (EMR) has been proposed as a primary method of managing patients with dysplasia- or mucosal-based cancers of the esophagus.OBJECTIVES: To evaluate the use of EMR for the treatment of Barrett’s esophagus with dysplasia or early adenocarcinoma, assessing efficacy, complication rates and long-term outcomes.METHODS: All patients who underwent EMR at St Paul’s Hospital (Vancouver, British Columbia) were reviewed. Eligible patients were assessed with aggressive biopsy protocols. Detected cancers were staged with both endoscopic ultrasound imaging and computed tomography. Appropriate patients were offered EMR using a commercially available mucosectomy device. EMR was repeated at six- to eight-week intervals until complete. Patients with less than one year of follow-up or who were undergoing other ablative methods were excluded.RESULTS: Twenty-two patients (all men) with a mean (± SD) age of 67±10.6 years were identified. The mean duration of gastroesophageal reflux disease was 17 years (range four to 40 years) and all were receiving proton pump inhibitor therapy. The mean length of Barrett’s esophagus was 5.5±3.5 cm. One patient had no dysplasia (isolated nodule), three had low-grade dysplasia, 15 had high-grade dysplasia (HGD) and three had adenocarcinoma. A mean of 1.7±0.83 endoscopic sessions were performed, with a mean of 6±5.4 sections removed. Following EMR, three patients developed strictures; two of these patients had pre-existing strictures and the third required two dilations, which resolved his symptoms. There were no other complications. Three patients underwent esophagectomy. Two had adenocarcinoma or HGD in a pre-existing stricture. The third patient had an adenocarcinoma not amenable to EMR. One patient with a long segment of Barrett’s esophagus underwent radiofrequency ablation. At a median follow-up of two years (range one to three years), the remaining 18 patients (82%) had no evidence of HGD or cancer.CONCLUSION: Most patients with esophageal dysplasia can be managed with EMR. Individuals with pre-existing strictures require other endoscopic and/or surgical methods to manage their dysplasia or adenocarcinoma.

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Navigated endoscopic surgery for multiloculated hydrocephalus in children

Journal of Neurosurgery Pediatrics ◽

10.3171/2010.1.peds09359 ◽

2010 ◽

Vol 5 (5) ◽

pp. 434-442 ◽

Cited By ~ 36

Author(s):

Matthias Schulz ◽

Georg Bohner ◽

Hannah Knaus ◽

Hannes Haberl ◽

Ulrich-Wilhelm Thomale

Keyword(s):

Mr Imaging ◽

Endoscopic Surgery ◽

Endoscopic Approach ◽

Ventricular Catheter ◽

Endoscopic Procedures ◽

Additional Surgery ◽

Multiloculated Hydrocephalus ◽

Ventricular Catheters ◽

Csf Diversion

Object Multiloculated hydrocephalus remains a challenging condition to treat in the pediatric hydrocephalic population. In a retrospective study, the authors reviewed their experience with navigated endoscopy to treat multiloculated hydrocephalus in children. Methods Between April 2004 and September 2008, navigated endoscopic procedures were performed in 16 children with multiloculated hydrocephalus (median age 8 months, mean age 16.1 ± 23.3 months). In all patients preoperative MR imaging was used for planning entry sites and trajectories of the endoscopic approach for cyst perforation and catheter positioning. Intraoperatively, a rigid endoscope was tracked by the navigation system. For all children the total number of operative procedures, navigated endoscopic procedures, implanted ventricular catheters, and drained compartments were recorded. In addition, postoperative complications and radiological follow-up data were analyzed. Results In 16 children, a total of 91 procedures were performed to treat multiloculated hydrocephalus, including 29 navigated endoscopic surgeries. Finally, 21 navigated procedures involved 1 ventricular catheter and 8 involved 2 catheters for CSF diversion via the shunt. The average number of drained compartments in a shunt was 3.6 ± 1.7 (range 2–9 compartments). In 9 patients (56%) a navigated endoscopic procedure constituted the last procedure within the follow-up period. One additional surgery was necessary in 3 patients (19%) after navigated endoscopy, and in 4 patients (25%) 2 further procedures were necessary after navigated endoscopy. Serial follow-up MR imaging demonstrated evidence of sufficient CSF diversion in all patients. Conclusions Navigated endoscopic surgery is a safe and effective treatment option for multiloculated hydrocephalus. The combination of the endoscopic approach and neuronavigation further refines preoperative planning and intraoperative orientation. The aim of treatment is to drain as many compartments as possible and as soon as possible, thereby establishing sufficient CSF drainage with few ventricular catheters in single shunt systems. Close clinical and radiological follow-up is mandatory because multiple revisions are likely.

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Prospective cohort study of mild cervical spondylotic myelopathy without surgical treatment

Journal of Neurosurgery Spine ◽

10.3171/2011.8.spine11395 ◽

2012 ◽

Vol 16 (1) ◽

pp. 8-14 ◽

Cited By ~ 36

Author(s):

Masatoshi Sumi ◽

Hiroshi Miyamoto ◽

Teppei Suzuki ◽

Shuichi Kaneyama ◽

Takako Kanatani ◽

...

Keyword(s):

Spinal Cord ◽

Surgical Treatment ◽

Mr Imaging ◽

Cervical Spondylotic Myelopathy ◽

Japanese Orthopaedic Association ◽

Rank Test ◽

Imaging Findings ◽

Significant Difference ◽

The Mean

Object Because the main pathology of cervical spondylotic myelopathy (CSM) is spinal cord damage due to compression, surgical treatment is usually recommended to improve patient symptoms and prevent exacerbation. However, lack of clarity of prognosis in cases that present with insignificant symptoms, particularly those of mild CSM, lead one to question the veracity of this course of action. The purpose of this study was to elucidate the prognosis of mild CSM without surgical intervention by evaluation of clinical symptoms and MR imaging findings. Methods Sixty cases of mild CSM (42 males and 18 females, average age 57.2 years) presenting with scores of 13 or higher on the Japanese Orthopaedic Association (JOA) scale were treated initially by in-bed Good Samaritan cervical traction without surgery. These patients were enrolled between 1995 and 2003 and followed up periodically until the date of myelopathy deterioration or until the end of March 2009. The deterioration of myelopathy was defined as a decline in JOA score to less than 13 with a decrease of at least 2 points. As a prognostic factor, the authors used their classification of spinal cord shapes at their lateral sides on axial T1-weighted MR imaging. “Ovoid deformity” was classified as a situation in which both sides were round and convex, and “angular-edged deformity” where one or both sides exhibited an acute-angled lateral corner. The duration of follow-up was assessed as the tolerance rate of mild CSM using Kaplan-Meier survival analysis and compared between 2 groups classified by MR imaging findings. Furthermore, differences between groups were analyzed by various applications of the log-rank test. Results Of the initial 60 cases, follow-up records existed for 55, giving a follow-up rate of 91.7% (38 males and 17 females, average age 56.1 years). The mean JOA score at end point was 14.1, which was not statistically different from the mean of 14.5 at the initial visit. Deterioration in myelopathy was observed in 14 (25.5%) of 55 cases, whereas 41 (74.5%) of 55 cases maintained mild extent myelopathy without deterioration through the follow-up period (mean 94.3 months). The total tolerance rate of mild CSM was 70%. However, there was a significant difference in the tolerance rate between the cases with angular-edged deformity (58%) and cases with ovoid deformity (95%; p = 0.049). Conclusions The tolerance rate of mild CSM was 70% in this study, which proved that the prognosis of mild CSM without surgical treatment was relatively good. However, the tolerance rate of the cases with angular-edged deformity was 58%. Therefore, surgical treatment should be considered when mild CSM cases show angular-edged deformity on axial MR imaging, even if patients lack significant symptoms.

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Distinct imaging patterns of pseudoprogression in glioma patients following proton versus photon radiation therapy

10.21203/rs.3.rs-197830/v1 ◽

2021 ◽

Author(s):

Reed Ritterbusch ◽

Lia M. Halasz ◽

Jerome J. Graber

Keyword(s):

Radiation Therapy ◽

Mr Imaging ◽

Tumor Progression ◽

Clinical Symptoms ◽

Molecular Subtype ◽

Tumor Grade ◽

Photon Radiation ◽

Low Grade ◽

Mean Time

Abstract Purpose Criteria by the Radiologic Assessment in Neuro-Oncology (RANO) group outline the diagnosis of pseudoprogression (Ps) after photon therapy for gliomas based on timing and location. We noted that patients receiving proton therapy manifested radiographic changes that appear different than Ps after photon therapy, which could be interpreted as tumor progression. In this study, we retrospectively reviewed MR imaging after proton or photon radiation for gliomas. We propose criteria to characterize proton pseudoprogression (ProPs) as distinct from Ps seen after photons. Methods Post-treatment MR imaging, clinical and pathological data of low grade glioma patients were reviewed. Overall, 57 patients receiving protons were reviewed for the presence of ProPs, and 43 patients receiving photons were reviewed for any equivalent imaging changes. Data collected included the location and timing of the new enhancement, tumor grade, molecular subtype, chemotherapy received, and clinical symptoms. Results Fourteen patients (24.6%) had new enhancement following radiation therapy that was unique to treatment with protons. The mean time to development of the ProPs was 15.4 months (7–27 months). We established the following criteria to characterize ProPs: located at the distal end of the proton beam; resolves without tumor-directed therapy; and subjectively multifocal, patchy, and small (< 1 cm). In the group receiving photons, none had changes that met our criteria for ProPs. Conclusion Patients who receive protons have unique imaging changes after radiation therapy. ProPs could be mistaken for tumor progression, but typically resolves on follow up. Further studies are needed to understand the radiobiology and pathophysiology underlying these imaging changes.

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Use of apparent diffusion coefficients in evaluating the response of vestibular schwannomas to Gamma Knife surgery

Journal of Neurosurgery ◽

10.3171/2012.7.gks121003 ◽

2012 ◽

Vol 117 (Special_Suppl) ◽

pp. 63-68 ◽

Cited By ~ 9

Author(s):

Chun-Chao Chuang ◽

Cheng-Siu Chang ◽

Yu-Sheng Tyan ◽

Keh-Shih Chuang ◽

Hsien-Tang Tu ◽

...

Keyword(s):

Mr Imaging ◽

Diffusion Coefficients ◽

Tumor Volume ◽

Imaging Studies ◽

Adc Value ◽

Apparent Diffusion Coefficients ◽

Apparent Diffusion ◽

Adc Values ◽

The Mean

Object Cellular density is a major factor responsible for changes in apparent diffusion coefficients (ADCs). The authors hypothesized that loss of tumor cells after Gamma Knife surgery (GKS) might alter ADC values. Magnetic resonance imaging, including diffusion-weighted (DW) imaging, was performed to detect cellular changes in brain tumors so that the authors could evaluate the tumor response to GKS as well as the efficacy of the procedure. Methods The authors conducted a prospective trial involving 31 patients harboring solid or cystic vestibular schwannomas (VSs) that were treated with GKS. The patients underwent serial MR imaging, including DW imaging, before GKS and at multiple intervals following the procedure. The authors observed the patients over time, evaluating MR imaging findings and clinical outcomes at 6-month intervals. The ADCs were calculated from echo-planar DW images, and mean ADC values were compared at each follow-up. Results The mean follow-up period was 36.5 months (range 18–60 months). Imaging studies showed a reduction in tumor volume in 19 patients (61.3%) and tumor growth arrest in 9 patients (29%). In the remaining 3 patients (9.7%), tumor enlargement was documented at 18, 36, and 42 months. The mean ADC value before GKS for all solid VSs was 1.06 ± 0.17 × 10−3 mm2/second, which significantly increased 6 months after GKS and continued to increase with time (p = 0.0086). The mean ADC value for treated solid tumors as of the last mean follow-up of 36 months (range 18–60 months) was 1.72 ± 0.26 × 10−3 mm2/second (range 1.50–2.09 × 10−3 mm2/second), which was significantly higher than that before GKS (p = 0.0001). Tumor volumes were positively related to ADC values (p = 0.03). The mean ADC value before GKS for all cystic VSs was 2.09 ± 0.24 × 10−3 mm2/second (range 1.80–2.58 × 10−3 mm2/second). The mean ADC value for treated cystic tumors as of the last mean follow-up of 38 months (range 18–48 months) was 1.89 ± 0.22 × 10−3 mm2/second. In 3 patients harboring solid VSs, the tumor enlarged after GKS but the ADC values were higher than those before GKS. The authors considered these tumors to be controlled and continued follow-up in the patients. Conclusions Apparent diffusion coefficient values may be useful for evaluating treatment results before any definite volume change is detected on imaging studies and for distinguishing radiation-induced necrosis from tumor recurrence in cases in which other imaging results are not definitive, as in cases of increased tumor volume or no volume change. The authors suggest that ADC measurements be included during routine MR imaging examinations for the evaluation of GKS results.

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Long-term Results of Low Grade Appendiceal Mucinous Neoplasm (LAMN): A Retrospective Analysis of 24 Patients

Archives of Iranian Medicine ◽

10.34172/aim.2021.87 ◽

2021 ◽

Vol 24 (8) ◽

pp. 615-621

Author(s):

Mustafa Gok ◽

Ugur Topal ◽

Muhammet Akyüz ◽

Abdullah Bahadır Öz ◽

Erdogan Sozuer ◽

...

Keyword(s):

Age Distribution ◽

Long Term Results ◽

Pathological Examination ◽

Resection Margins ◽

Low Grade ◽

Common Symptom ◽

Mucinous Neoplasm ◽

The Mean

Background: Appendix tumors are rare tumors found in the gastrointestinal tract, observed at a rate of about 0.2%–0.3%. Our aim in this study was to present the clinicopathological classification, treatment and long-term prognosis of patients with low grade appendiceal mucinous neoplasm (LAMN). Methods: Patients who underwent surgery in the Erciyes University Department of (Kayseri, Turkey), Department of General Surgery between December 2010 and December 2018, and who had LAMN as a result of pathology were included in our study. Demographic data, clinical and pathological features of the disease, their treatment and follow-up results after treatment were reviewed retrospectively. Results: We included 24 patients in the study. Of these patients, 10 (41.6%) were male. The mean age distribution was 56.4 ± 20.3 (21–91) years. Appendectomy was performed in 14 patients, and additional organ resections were performed in 8 patients. The most common symptom at the time of presentation was abdominal pain (79.1%; 95% CI, 58.3–91.7). The most common preliminary diagnosis in the preoperative period was acute appendicitis (50%; 95% CI, 29.2–70.8). Mean postoperative hospitalization time was 7.4 ± 7.96 (2–31) days. On pathological examination, appendectomy resection margins were positive in two patients. The mean (median) postoperative follow-up was 31.25 ± 23.9 (27) (1–90) months. One-year survival was 91.6%, and 5-year survival was 83.3%. Recurrence was detected in three patients during the follow-up period. Conclusion: If appendix mucinous neoplasia (AMN) is suspected in patients undergoing surgery with an initial diagnosis of acute or plastron appendicitis, care should be taken to remove the lesion without perforation. Pseudomyxoma peritonei, which may develop as a result of perforation, is associated with recurrence and decreased survival.

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