Apendiks Tümörleri
Özet
Apendiks tümörleri, gastrointestinal sistemin nadir görülen tümörlerinden olup histolojik olarak epitelyal ve non-epitelyal olarak iki ana gruba ayrılmaktadır. Epitelyal tümörler müsinöz neoplaziler, kolonik ve goblet hücreli adenokarsinom olarak üç gruba ayrılmaktadır. Apendiks tümörlerinde primer tedavi yöntemi cerrahidir ve seçilmiş hastalarda adjuvan kemoterapi önerilmektedir. Epitelyal tümörlerin takibi temelde kolon kanserleri ile benzerdir ve klinik, biyokimyasal belirteçler ile görüntüleme yöntemlerinin birlikte kullanılması önerilmektedir. Non-epitelyal apendiks tümörlerinin büyük çoğunluğunu ise nöroendokrin tümörler oluşturmaktadır. Nöroendokrin tümörlerin prognozu, epitelyal tümörlere göre daha iyi olup tedavisi öncelikli olarak cerrahidir. Tümör çapı, prognozu belirleyen en önemli faktördür ve özellikle 2 cm’den büyük tümörlerde rekürrens riski yüksek olması sebebiyle yakın takip gerekmektedir. Takipte kromogranin A benzeri tümör belirteçleri ile birlikte BT ve MRI gibi görüntüleme modaliteleri kullanılmaktadır. Sonuç olarak, histolojik olarak çeşitliliği fazla olan apendiks tümörlerinin takibi tümörün histolojik özelliklerine ve evresine göre planlanmalıdır.
Appendix tumors are rare tumors of the gastrointestinal system and are histologically divided into two main groups; epithelial and non-epithelial tumors. Epithelial tumors are further subdivided into three groups; mucinous neoplasms, colonic type adenocarcinomas, and goblet cell adenocarcinomas, The primary treatment method for appendix tumors is surgery, and adjuvant chemotherapy is recommended for selected patients. Follow-up strategies are similar to that of colorectal cancer and includes the combined use of clinical evaluation, biochemical markers, and imaging. The surgical approach and systemic chemotherapy vary based on the tumor's histology The majority of non-epithelial appendiceal tumors are neuroendocrine tumors. Neuroendocrine tumors have a better prognosis compared to epithelial tumors, and surgery is the primary treatment. Tumor size is the most important prognostic factor, and tumors larger than 2 cm require close follow-up due to a higher risk of recurrence.. Follow-up includes the use of tumor markers such as chromogranin A, along with imaging modalities including CT and MRI. In conclusion, the management and follow-up of appendix tumors, which exhibit significant histological diversity, requires a tailored approach based on the tumor histology type and stage.
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