Appendix cancer overview: Difference between revisions
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* Appendix cancer is classified according to the histological findings. According to WHO classification there are four major groups of appendix cancer including epithelial tumors, non-epithelial tumors, secondary tumors, and hyperplastic (metaplastic) polyps.<ref name="WHO">Chapter 5: Tumours of the Appendix - IARC. https://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb2/bb2-chap5.pdf Accessed on January 15, 2019</ref> Carcinoid (well differentiated endocrine neoplasm), and adenocarcinoma are two major subtypes of epithelial tumors, making the majority of appendix cancer cases. | * Appendix cancer is classified according to the histological findings. According to WHO classification there are four major groups of appendix cancer including epithelial tumors, non-epithelial tumors, secondary tumors, and hyperplastic (metaplastic) polyps.<ref name="WHO">Chapter 5: Tumours of the Appendix - IARC. https://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb2/bb2-chap5.pdf Accessed on January 15, 2019</ref> Carcinoid (well differentiated endocrine neoplasm), and adenocarcinoma are two major subtypes of epithelial tumors, making the majority of appendix cancer cases. | ||
==Pathophysiology== | ==Pathophysiology== | ||
The pathophysiology of appendix cancer depends on the histological subtype. There are two major subtypes of appendix cancer, adenocarcinomae and carcionid tumors. While carcinoid tumors arises from enterochromaffin cells (Kulchitsky cells), which are secretory cells that are normally involved in neuroendocrine hormonal secretions, adenocarcinomae are the result of mutations in mucous producing epithelial cells. Their physiology, pathophysiology, genetic pathways, prognosis as well as epidemiology are different and hence discussed separately. The progression to adenocarcinoma usually involves the ''[[KRAS]], [[APC]], [[TP53]],'' and ''RAF'' pathways, While ''[[β-catenin]]'', ''[[NF1]]'', and ''[[MEN1]]'' genes are major contributors of carcinoid tumor s progression. | |||
==Causes== | ==Causes== | ||
Revision as of 20:26, 5 February 2019
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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
Historical Perspective
Appendix cancer was first described in the published literature by Sir George Thos. Beatson, an English surgeon, in 1913.[1]Development of surgical sciences revolutionized cancer care, appendix cancer was not an exception. Introduction of chemotherapy agents such as 5-fluorouracil (5-FU) Irinotecan, Oxaliplatin, Vascular endothelial growth factor receptor inhibitors (bevacizumab), Epidermal growth factor receptor inhibitors (cetuximab and panitumumab), Aflibercept, Regorafenib: inhibitor of angiogenic tyrosine kinases (including the VEGF receptors 1,2, and 3), Capecitabine as well as introduction of intraperitoneal chemotherapy including hyperthermic intraperitoneal chemotherapyadvanced appendix cancer treatment. Development of new Imaging modalities such as CT scan, MRI as well as specific imaging modalities such as Somatostatin scintigraphy also transfigured approaching to the patients with appendix cancer. Genetic studies introduced novel horizons in approaching patients with appendix cancer.
Classification
- Appendix cancer is classified according to the histological findings. According to WHO classification there are four major groups of appendix cancer including epithelial tumors, non-epithelial tumors, secondary tumors, and hyperplastic (metaplastic) polyps.[2] Carcinoid (well differentiated endocrine neoplasm), and adenocarcinoma are two major subtypes of epithelial tumors, making the majority of appendix cancer cases.
Pathophysiology
The pathophysiology of appendix cancer depends on the histological subtype. There are two major subtypes of appendix cancer, adenocarcinomae and carcionid tumors. While carcinoid tumors arises from enterochromaffin cells (Kulchitsky cells), which are secretory cells that are normally involved in neuroendocrine hormonal secretions, adenocarcinomae are the result of mutations in mucous producing epithelial cells. Their physiology, pathophysiology, genetic pathways, prognosis as well as epidemiology are different and hence discussed separately. The progression to adenocarcinoma usually involves the KRAS, APC, TP53, and RAF pathways, While β-catenin, NF1, and MEN1 genes are major contributors of carcinoid tumor s progression.
Causes
Differentiating Appendix cancer from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Interventions
Surgery
Primary Prevention
Secondary Prevention
References
- ↑ Beatson GT (1913) Note on a Case of Carcinoma of the Vermiform Appendix in a Girl, Aged 20 Years. Glasgow Med J 80 (6):418-422. PMID: 30435413
- ↑ Chapter 5: Tumours of the Appendix - IARC. https://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb2/bb2-chap5.pdf Accessed on January 15, 2019