NEOPLASMS OF THE APPENDIX

- It is rare.

- It is often postappendicectomy histological diagnosis.

- Cystic neoplasms of appendix: Simple cyst (non-neoplastic mucocele); mucinous cystadenoma; mucinous cystadenocarcinoma (most common form of cystic neoplasms); pseudomyxoma peritonei. Simple cyst is non-neoplastic obstruction of the lumen and is less than 2 cm in size which contains mucin. Mucinous cystadenoma attains progressively large size of up to 8 cm with CT showing calcification of the wall. Laparoscopic appendicectomy is not used in mucinous cystadenoma. Hemicolectomy is done in mucinous cystadenocarcinoma and cystadenoma of large size and if base is involved.

- Carcinoid tumour is the most common type. It is less aggressive. It is often incidentally found. It is arising from Kulchitsky cells. in crypts of Lieberkuhn (argentaffin tissue). It is ten times more common than other types (One in 400 appendices). Commonly its location is in the tip. 75% are less than 1 cm; 15% are 1–2 cm; 10% are > 2 cm in size. It stains chromograninB immunohistochemically. Distant and nodal spread occurs if tumour is more than 2 cm. Carcinoid of appendix may be goblet cell type or classical type histologically. Goblet cell has got more mortality than classic type. Right hemicolectomy is done if base is involved or size is more than 2 cm or nodes are involved. 5-year survival is 90%.

- Primary adenocarcinoma of the appendix is rare. It can be mucinous (common) or colonic (less common) type. Acute presentation

as appendicitis is common in colonic type. It is staged as Duke’s staging A, B, C and D. 5-year survival rate for each is 100%; 65%; 50% and 5% respectively. Mucinous type has got better prognosis. 5-year survival for mucinous type is 70% and colonic type is 40%. Mucinous type can rupture into the peritoneal cavity and can cause pseudomyxoma peritonei.

HOMEOPATHIC MANAGEMENT: -

The medicines that can be thought of use are:-

• Arnica
• Arsenic
• Belladonna
• Bryonia
• Colocynth
• Ferrum phos