A38 INCIDENCE OF APPENDICULAR TUMORS TREATED WITH PRIMARY OR DELAYED APPENDECTOMY, COLECTOMY, OR RIGHT HEMICOLECTOMY IN THE ADULT POPULATION IN A REGIONAL ONTARIO HOSPITAL.

Appendicular neoplasms are uncommon to rare tumors of the gastrointestinal tract. Malignant tumor of the appendix account for ~0.5% of all tumors arising from the gastrointestinal tract. Due to their low frequency their true etiopathogenesis and biologic behavior remain poorly understood. This lack of knowledge has created controversy around the classification of primary epithelial tumors, especially when there is peritoneal spread. Given these discrepancies, we sought to investigate their incidence in the adult population captured by Grey Bruce Health Sciences in order to raise awareness that tumors of the appendix may occur in the setting of acute abdominal pain and as an incidental finding. The surgical pathology data base (Copath) at GBHS collected over the past 10 years was reviewed to determine the incidence of primary appendicular neoplasms, benign or malignant, in the setting of primary and delayed appendectomy, colectomies, and right hemicolectomy. Appendix removal was the only inclusion criterion. Additional data was collected for cases diagnosed with appendiceal tumors by reviewing Power Chart.Statistical analysis for significant differences will be performed according to the two-tailed Student’s t-test for unpaired data and analysis of variance when appropriate. For all determinations, results will be expressed as the mean ± SEM; N will indicate the number of patients. P <0.05 will be considered to be statistically significant. Of the 2301 primary and delayed appendectomies, colectomies, and right hemicolectomies performed in the last 10 years, 68 cases (~2.95%) were diagnosed with an appendicular neoplasm. Aside from common appendiceal tumors, we found two very rare cases of a primary gastrointestinal stromal tumor and a possible primary small cell carinoma. There was a slight predominance toward females (57%) and 70% of cases occurred after the age of 60. The most common complaint being RLQ pain (59%). Of the 68 total neoplasms, 14 were removed as delayed appendectomies with none being initially suspected of neoplasm. Of all delayed appendectomies performed in the last 5 years, 16% were diagnosed with an appendiceal tumor, as opposed to only 2% of primary appendectomies. We concluded that given the uncommon nature of appendicitis at ages greater than 60 years, these patients, particularly females, who present with RLQ pain should be suspected of a possible appendiceal tumor. None

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