Appendiceal Cancer

　　I. Etiology

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　　II. Pathogenesis

　　1. Pathological Classification

　　Appendiceal adenocarcinoma has two types: mucinous type and colonic type.

　　(1) Mucinous type: Also known as cystadenocarcinoma, originating from cystadenoma, it is mostly well-differentiated cells, very similar to ovarian cystadenocarcinoma, prone to rupture and peritoneal dissemination, leading to pseudomyxoma peritonei, and easy to recur after surgery.

　　(2) Colonic type: It is a polypoid or ulcerous tumor originating from tubular or tubular villous adenoma, similar to colonic adenocarcinoma, and metastasizes along the lymphatic and hematogenous pathways.

　　2. Routes of Metastasis

　　Appendiceal adenocarcinoma is prone to occur at the root of the appendix, therefore, it is easy to invade the ileocecal region and colon. The main routes of metastasis include: ① Lymphatic route, the colonic type is the most common. Once the tumor invades the submucosal layer, it is highly prone to metastasize along the mesoappendiceal lymph nodes, ileocecal artery lymph nodes, right hemicolonic artery lymph nodes, and even abdominal aorta lymph nodes. ② Hematogenous metastasis, it can metastasize to the liver along the portal venous system and further to tissues and organs throughout the body. ③ Direct infiltration and implantation, it can invade adjacent mesentery, cecum, ureter, and even pelvic and abdominal implantation and metastasis. The mucinous type is prone to this type of metastasis, and during surgery, several to hundreds of gelatinous nodules as large as eggs and as small as sesame seeds can be seen, often accompanied by ascites. The colonic type adenocarcinoma with peritoneal metastasis is mainly mucinous adenocarcinoma, followed by differentiated adenocarcinoma, which often appears in advanced patients.

　　1. Appendiceal Perforation

　　Due to the thin wall and narrow lumen of the vermiform appendix, along with the obstruction of secretions and tumor infiltration, appendiceal perforation is prone to occur. Clinically, local peritoneal irritation symptoms may appear, which are highly susceptible to the implantation of tumor cells in the peritoneal cavity.

　　2. Intestinal obstruction

　　In cases of mucosal adenocarcinoma with peritoneal metastasis, mechanical or functional intestinal obstruction may occur due to tumor compression or invasion of the intestinal tract. If not treated actively, patients may die due to intestinal obstruction.

　　Patients with appendiceal cancer are mostly young people and tend to occur in the gastrointestinal tract, such as the stomach, small intestine, and large intestine. If symptoms of appendicitis such as lower abdominal pain occur, it is best to go to a large hospital for treatment. Appendiceal adenocarcinoma has two types: mucosal type and colonic type.

　　To improve the survival rate of the disease, the preoperative diagnostic rate is crucial. However, achieving this is quite challenging. Mayo Clinic reported that a group of patients with appendiceal adenocarcinoma were not diagnosed preoperatively, and only 42% were diagnosed during surgery. Most were found to have cancer during postoperative pathological examination. Therefore, clinical doctors should be vigilant about the possibility of adenocarcinoma when dealing with appendicitis, and the appendiceal lumen should be incised during surgery to check for tumors. Frozen section examination should be performed for suspicious cases. Efforts should be made to perform primary right hemicolectomy for confirmed cases. In addition, for well-differentiated appendiceal adenocarcinoma, postoperative close follow-up is needed to provide timely treatment before the formation of pseudomyxoma peritonei. Literature reports that 35% to 60% of patients may simultaneously or at different times develop intestinal or extraintestinal tumors, so preoperative diagnosis should be made to prevent missed diagnosis, abdominal tumors should be excluded during surgery, and synchronous tumors should be found during postoperative follow-up.

　　Appendiceal Cancer. Common symptoms of the disease are the appearance of hidden pain in the lower right abdomen, which is easy to be misdiagnosed as chronic appendicitis. It is easy to distinguish through incisional pathological examination, barium enema examination, or B-ultrasound examination..

　　In addition to routine treatment, attention should also be paid to the following aspects of diet for appendiceal cancer:

      1. Eat anti-cancer foods;

　　2. Eat foods that promote intestinal peristalsis and absorption;

　　3. Eat foods rich in vitamins.

　　Appendiceal CancerFor those who should undergo surgery, chemotherapy should be combined after surgery. It is essential to rest well and strengthen nutritional supplementation after surgery.It is recommended to adopt the dynamic therapy of traditional Chinese medicine and take Chinese herbs to treat the disease. By killing cancer cells, eliminating tumors, adjusting the balance of yin and yang, strengthening the body and expelling pathogenic factors, both symptoms and root causes are treated.. .