The appendix is an approximately 10 cm long bulge at the transition from the small intestine to the large intestine. It consists mainly of lymphatic tissue and serves the immune system. In very rare cases, the cells of the appendix can degenerate, leading to a tumour of the appendix. Appendix cancer accounts for less than 1% of all cancers of the gastrointestinal tract and is usually treated in the same way as colon cancer.
Causes of appendix cancer
The causes for the degeneration of cells are manifold. Depending on which type of cell degenerates, different forms of cancer develop. The most common form is mucinous adenocarcinoma, which develops from the mucinous cells in the appendix.
There are certain mutations in the DNA that can promote degeneration in the appendix. These include the TP53 mutation and the GNAS mutation. In addition, a so-called neuroendocrine tumour (NET) can also be the cause of appendicitis. This type of tumour affects the appendix in 40% of cases.
Diagnosis
It is not easy to diagnose appendicitis because this disease causes hardly any early symptoms. The first steps are to describe the symptoms and to ask for the medical history (anamnesis). Then follows the physical examination.
In addition, a sonography can be performed, although this does not always give clear results. If intestinal cancer is suspected, a colonoscopy is very important, as it allows tissue samples to be taken. The examination of these samples provides information about the degeneration of the cells.
Other imaging procedures such as computer tomography can be connected to rule out the possibility of cancer spreading. If a neuroendocrine tumour (NET) is suspected, the serotonin level in the blood and 5-hydroxyindoleacetic acid in the 24-hour urine would be determined. In addition, a somatostatin receptor scintigraphy would be performed. Learn how colon cancer is diagnosed.
These are the symptoms of appendicitis
Appendix cancer causes almost no early symptoms. Only when the tumour gets bigger, it can cause symptoms. The appendix is often constricted so that bacteria can multiply.
This can lead to appendicitis (inflammation of the appendix). This must be treated surgically and a tissue sample is always taken. In this way, the diagnosis can be made in this case.
Another symptom of advanced appendicitis can be a hardening in the lower abdomen or pelvic area. This can be caused by the tumour and can also lead to pain. In severe cases, the appendix wall can be destroyed by the tumour, causing the cancer cells to spread in the abdomen (pseudomyxoma peritonei).
The cells produce a gel-like fluid that causes adhesions in the abdomen and disperses the tumour. In the case of a neuroendocrine tumour (NET), diarrhoea, abdominal cramps and sudden red discolouration of the skin with hot flushes can occur. are
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