Clinical Approach to Incidentally Identified Appendiceal Neuroendocrine Neoplasms After Appendicectomy in Children

Neuroendocrine Tumours (NET) are the commonest type of tumours affecting the appendix. The majority of cases are diagnosed incidentally on histological examination of the resected appendix after Appendicectomy. There is debate about the optimal surgical management for localized appendiceal NETs that are impacted by many factors. The data to guide therapy in pediatric cases are limited due to the paucity of these tumors. We present the case of 10 years-old boy with abdominal pain, fever and vomiting appeared for 2 days. On physical examination, a tenderness in the right lower quadrant of the abdomen. Laboratory tests showed an inflammatory syndrome. Ultrasonography revealed findings with acute appendicitis. The patient underwent an uneventful appendectomy for an acutely phlegmoneous appendix. Histological examination showed a 0.3 cm well-differentiated neuroendocrine tumor grade 1 of the distal appendix with clean resection margins. The follow-up was uneventful and no further procedures were performed. Appendicular NET are rare and usually asymptomatic and diagnosed incidentally on histological examination after appendectomy. Pediatric appendiceal NET tends to have a benign clinical course with excellent prognosis. Simple appendectomy is adequate treatment for NET less than one cm in diameter.