Appendix tumours

The appendix is a blind-ending tube attached to the first part of the large bowel (caecum), often about 10cm in length.

The appendix is not thought to have any significant function. Abnormal growths (tumours) can develop in the appendix, which can be benign or cancerous (with the ability to spread to other parts of the body). They are difficult to diagnose and often go unnoticed unless the tumour spreads to other parts of the body or are a chance finding after appendicectomy. Symptoms may include abdominal pains, swelling, loss of appetite, nausea and vomiting, and weight loss. The Christie Colorectal and Peritoneal Oncology Centre is a national specialist centre for the treatment of Appendix tumours, and some of the types we commonly see include:

Neuroendocrine (Carcinoid) Tumours of the Appendix

These are the most common type of appendix tumour and arise from hormone producing cells that are normally present in small numbers in organs throughout the body. If found at appendicectomy and confined to the appendix, these often require no further treatment. However the size of the tumour, growth rate, involvement of lymph and blood vessels, and perforation of the appendix are all factors that need to be considered and may lead to a need for further surgery. Carcinoid tumours can also occur elsewhere in the body.

Low Grade Mucinous Neoplasms of the Appendix

These tumours produce a jelly-like substance (mucin) that collects within the appendix and forms a mucocoele. If this mucin escapes then there is a risk of developing pseudomyxoma peritoneii (PMP).

Adenocarcinomas of the Appendix

These may be mucinous (producing a jelly-like substance), colonic type (behaving like colorectal cancer), or signet-ring cell type (with cells that under the microscope look like they contain a signet ring). These tumours can be aggressive and should be referred to a specialist centre like The Christie Colorectal and Peritoneal Oncology Centre for advice and treatment.

Goblet Cell Carcinoid Tumours

This is a rare and aggressive type of tumour that almost exclusively affects the appendix. It has feature of both neuroendocrine tumours and adenocarcinomas of the appendix. Patients are most commonly diagnosed after undergoing surgery for an episode of appendicitis. When looked at under a microscope, the cells they contain look like miniature wine goblets. These tumours should be referred to a specialist centre like The Christie Colorectal and Peritoneal Oncology Centre for advice and treatment.

Appendix tumours