Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for evaluation of an appendiceal mass incidentally discovered during [appendectomy/imaging]. Patient reports [no/presence of] symptoms of carcinoid syndrome (flushing, diarrhea, wheezing). No history of weight loss, night sweats, or abdominal pain. Review of systems negative for systemic neuroendocrine symptoms.
Clinical Examination Findings
Abdomen: Soft, non-tender, non-distended. No palpable masses or organomegaly. Surgical scar from prior appendectomy is well-healed without signs of infection or hernia. Cardiovascular: Regular rate and rhythm, no murmurs. Pulmonary: Clear to auscultation bilaterally. Skin: No evidence of cutaneous flushing or telangiectasia.
Treatment Protocol
Treatment plan based on tumor size and location: 1) Tumors <1cm: Simple appendectomy is curative. 2) Tumors 1-2cm: Appendectomy vs. right hemicolectomy based on location (base involvement) and high-risk features. 3) Tumors >2cm: Right hemicolectomy indicated. Post-operative surveillance with serial CgA (Chromogranin A) levels and abdominal imaging as per NCCN guidelines.