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Histopathology reports from 581 patients were reviewed across two cohorts: mucinous ovarian neoplasms and cytoreductive surgery for gynecological cancers. Using the updated 2019 WHO nomenclature, incidence differed between cohorts and frequent extraovarian mucinous metastasis to the ovary was observed, alongside limited gross–microscopic correlation, supporting complete microscopic appendix examination.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/primary-lesions-of-the-appendix-in-patients-undergoing-surgery-for-gynecological-tumors-article/367812/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/primary-lesions-of-the-appendix-in-patients-undergoing-surgery-for-gynecological-tumors-article/367812.png","ImageObject",300,407,{"name":42,"@type":43},"Jasmine","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-27","2026-09-23",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",8,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What was the study objective regarding appendix lesions in these patients?","Question",{"text":63,"@type":64},"To investigate the incidence of primary appendix lesions in two cohorts: patients who underwent appendicectomy for mucinous ovarian neoplasms and those who underwent cytoreductive surgery for gynecological malignancies.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How were appendiceal lesions classified in the study?",{"text":68,"@type":64},"The study used the updated 2019 WHO nomenclature to classify appendiceal lesions.",{"name":70,"@type":61,"acceptedAnswer":71},"Why does the article emphasize microscopic examination even when gross findings are normal?",{"text":72,"@type":64},"Because there was poor correlation between gross and microscopic confirmation, with a portion of macroscopically normal appendices showing appendiceal pathology, highlighting the need for full microscopic 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Surgical Pathology 2025, Vol. 33(7) 1615–1623  \n© The Author(s) 2025  \nArticle reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI:](DOI: 10.1177/10668969251333119)[ 1](DOI: 10.1177/10668969251333119)[0.](DOI: 10.1177/10668969251333119)[11](DOI: 10.1177/10668969251333119)[77/](DOI: 10.1177/10668969251333119)[1](DOI: 10.1177/10668969251333119)[066896925](DOI: 10.1177/10668969251333119)[1](DOI: 10.1177/10668969251333119)[333](DOI: 10.1177/10668969251333119)[11](DOI: 10.1177/10668969251333119)[9](DOI: 10.1177/10668969251333119)[ ](DOI: 10.1177/10668969251333119)[journals.sagepub.com/home/ijs](journals.sagepub.com/home/ijs)  \nSana Khalid, MBBS, MRCP, FRCPath 1  , Nabil El-Masry, MBBCh, MSc, MD, FRCS2, Robert D Goldin, MBChB, MD, Med3, and  \nMona El-Bahrawy, MBBCh, MSc, PhD, FRCPath4   \nAbstract  \nAppendiceal neoplasms are an incidental finding in \u003C1% of all appendicectomy specimens. Their incidence rates are largely based on appendectomies performed for appendicitis. Appendicectomy is often performed as part of cytoreductive surgery for gynecological malignancies. This is to reduce the risk of occult metastatic disease and to mitigate the morbidity of acute appendicitis in patients undergoing chemotherapy for cancers. The objective of this study was to investigate the incidence of primary lesions of the appendix in 2 cohorts of patients who underwent appendicectomy: patients who had surgery for mucinous neoplasms of the ovary and patients who had cytoreductive surgery for gynecological malignancies. This study looked at the histopathology reports of 581 patients covering both cohorts. Appendicectomy in the setting of mucinous neoplasms of the ovary was done in 187 patients and as part of cytoreductive surgery for gynecological malignancies in 182 patients. We used the updated 2019 WHO nomenclature to classify the appendiceal lesions. The 2 cohorts had an incidence of 13%(25/187) and 7%(12/182) of appendiceal lesions. The appendix was noted to be the frequent primary site of extraovarian mucinous tumor metastasis to the ovary with a frequency of 56%(14/25) in patients with mucinous ovarian tumors; the highest cited in literature to date. We also noted poor correlation between gross and microscopic confirmation of appendiceal lesions with 7% of all macroscopically normal appendices harboring an appendiceal pathology. The study highlights the importance of appendicectomy during surgery for ovarian mucinous neoplasms and as part of cytoreductive surgery for gynecological malignancies. It also signifies the importance of microscopic examination of the whole appendix, especially when no gross abnormality is detected.  \nKeywords  \nappendix, cytoreductive surgery, mucinous tumors, gynecological cancers  \nIntroduction  \nThe incidence of appendiceal cancer is low and it is predominantly an incidental diagnosis 1 found in less than 1% of all appendicectomy specimens.2–4 Because of their rarity, they also pose a challenge for clinicians and radiologists alike. An appendicectomyin the setting of a gynecological malignancy is often performed as part of cytoreductive surgery because of the risk of occult metastatic disease and to mitigate the morbidity of acute appendicitis in patients undergoing chemotherapy for ovarian cancers. Moreover, in the setting of mucinous ovarian neoplasms, an appendicectomy can help in ascertaining or excluding the appendix as the site of primary cancer. 5,6  \nThere have been recent advances in the understanding and the nomenclature of appendiceal neoplasms. For instance, the goblet cell carcinoid is renamed as goblet  \ncell adenocarcinoma in view of the potential aggressive behavior of this entity.7 Moreover, previously benign entities like hyperplastic polyps are considered neoplastic in view of emerging mutation found in these le","cbCaioapDAkfAYy3","https://ap.wps.com/l/cbCaioapDAkfAYy3","pdf",1081075,"English","# Abstract\n# Keywords\n# Introduction\n## Incidence and clinical challenge\n## Recent advances in nomenclature","[{\"question\":\"What was the study objective regarding appendix lesions in these patients?\",\"answer\":\"To investigate the incidence of primary appendix lesions in two cohorts: patients who underwent appendicectomy for mucinous ovarian neoplasms and those who underwent cytoreductive surgery for gynecological malignancies.\"},{\"question\":\"How were appendiceal lesions classified in the study?\",\"answer\":\"The study used the updated 2019 WHO nomenclature to classify appendiceal lesions.\"},{\"question\":\"Why does the article emphasize microscopic examination even when gross findings are normal?\",\"answer\":\"Because there was poor correlation between gross and microscopic confirmation, with a portion of macroscopically normal appendices showing appendiceal pathology, highlighting the need for full microscopic evaluation.\"}]","Primary Lesions of the Appendix in Patients Undergoing Surgery for Gynecological Tumors - Article | PDF",1790172803,23]