Appendiceal neuroendocrine neoplasms: diagnosis and management

  1. Ashley B Grossman3
  1. 1Department of Pathophysiology, National University of Athens, Greece
    2Neuroendocrine Tumor Unit, Endocrinology and Metabolism Service, Department of Medicine, Hadassah-Hebrew University Hospital, Jerusalem, Israel
    3Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
  1. Correspondence should be addressed to K Alexandraki; Email: alexandrakik{at}
  1. Figure 1

    A cross-section of the appendix showing the four layers that form the appendiceal wall: serosa, muscularis externa, submucosa and mucosa. Neuroendocrine cells are located in the mucosa (Epithelial neuroendocrine cells (ENCs)) and in the submucosa (subepithelial neuroendocrine cells (SNCs)).

  2. Figure 2

    Anatomy of the appendix and surrounding organs.

  3. Figure 3

    Therapeutic and follow-up algorithm for appendiceal neuroendocrine neoplasms incidentally found after appendicectomy for acute appendicitis or other abdominal or gynaecological procedures. aNENs, appendiceal neuroendocrine neoplasms; MAI, mesoappendiceal fat invasion; MRI, magnetic resonance imaging; NEN, neuroendocrine neoplasm; SRI, somatostatin receptor imaging; US, ultrasound scan. *SRI will depend on the expertise and choice of individual units due to the lack of evidence. **Patients who cannot be submitted to surgical procedures because of co-morbidities or who are unwilling to undergo operation. ***Bucher et al. 2004, Connor et al. 1998, Modlin et al. 2003, Modlin & Sandor 1997.

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