Incidental detection of an appendiceal neuroendocrine tumor in a right hemicolectomy specimen for colonic adenocarcinoma: A case report.

introduction and importanceIncidental detection of neuroendocrine tumors (NETs) of the appendix is rare, often discovered during surgeries for other conditions. This report emphasizes the importance of thorough pathological evaluations in colorectal surgeries. CASE PRESENTATION: A 48-year-old male presented with intermittent abdominal pain, weight loss, and altered bowel habits. Colonoscopy and biopsy confirmed adenocarcinoma of the right colon. The patient underwent a right hemicolectomy. Histopathological examination revealed a moderately differentiated adenocarcinoma of the ascending colon (pT3N2b) and an incidental 0.8 cm well-differentiated NET at the tip of the appendix. The NET was low-grade (G1) with no lymphovascular invasion or metastasis. The patient received adjuvant chemotherapy with oxaliplatin and capecitabine for the colonic adenocarcinoma. The incidental NET did not alter the chemotherapy regimen due to its low-risk features. DISCUSSION: Although, the presence of the NET did not alter the chemotherapy regimen, given its small size and low-grade nature. However, the discovery of this incidental tumor highlights the need for diligent follow-up, as patients with synchronous tumors may have an increased risk of recurrence or development of new malignancies.

conclusionThis case highlights the significance of meticulous pathological examination in colorectal surgeries, as incidental findings can significantly impact patient management and follow-up. Despite the typically indolent nature of small appendiceal NETs, their detection is crucial for accurate staging and appropriate patient care.