Appendix cancer history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]

Overview

The majority of patients with appendix cancer are asymptomatic. Patients may complain of vague abdominal pain or discomfort and/or girdle size changes. However, most of them are presenting with acute appendicitis due to obstruction of the appendix by tumor, or present with malignancy complications like pseudomyxoma peritonei; the rest of diagnosed cases are result of serendipitous finding in imaging studies or discovered during laparotomy or laparoscopy because of cancer complications. The patients complains and presentation is influenced by the tumor histology and stage and ranges from a small asymptomatic adenocarcinoma to a metastatic carcinoid tumor with liver metastasis and carcinoid syndrome signs, symptoms and complications.

History and Symptoms

• The majority of patients with appendix cancer are asymptomatic.

• Patients may complaint of vague abdominal pain or discomfort and/or girdle size changes.
• However, most of them are presenting with acute appendicitis due to obstruction of the appendix by the tumor, only after pathological studies their diagnosis is revealed.
• They may present with malignancy complications like pseudomyxoma peritonei.
• Rest of the diagnosed cases are result of serendipitous finding in imaging studies or discovered during laparotomy or laparoscopy because of cancer complications.
• The patients complaints and presentation is influenced by the tumor histology and stage. Range from a small asymptomatic adenocarcinoma to a metastatic carcinoid tumor with liver metastasis and carcinoid syndrome signs, symptoms and complications such as diarrhea, flushing, palpitation and heart valvular problems. 

History

Patients with appendix cancer may have a positive history of:

• MEN1 Syndome
• Ulcerative colitis
• Neurofibromatosis type 1
• HNPCC
• Smoking

Common Symptoms

• Common symptoms of appendix cancer are as follows:
  • Asymptomatic
  • Vague chronic abdominal pain
    • Periumbilical
    • Right lower quadrant
  • Acute appendicitis symptoms like:
    • Loss of appetite
    • Nausea
    • Typical appendicitis abdominal pain which starts from preumblical region and move to Mcburny point.
    • Vomiting
• If complicated, may present with acute abdomen.
• Other nonspecific symptoms of appendix cancer may include the following:

• Loss of appetite
• Nausea
• Vomiting
• Diarrhea
• Micturition
• Tenesmus
• Indigestion
• Flatulence
• Bowel irregularity

Less Common Symptoms

Around 5% of the patients with appendix carcinoid tumors develop carcinoid syndrome which presents with:

• Diarrhea
• Flushing
• Palpitation