More than just appendicitis: incidental detection of a serrated polyp with malignant potential

TL;DR

A serrated polyp with cancer potential was found during surgery for appendicitis, highlighting the need for thorough examination of appendectomy samples.

Contribution

Highlights the importance of routine histopathological evaluation of appendectomy specimens to detect incidental serrated polyps.

Findings

An incidental serrated polyp was detected in a 41-year-old patient during appendectomy.

Routine histopathological evaluation of appendectomy specimens can reveal lesions with malignant potential.

Early detection of such polyps may aid in colorectal cancer prevention.

Abstract

Acute appendicitis is a common surgical emergency, sometimes revealing incidental neoplastic lesions such as serrated polyps, which have malignant potential through the serrated pathway of colorectal carcinogenesis. A 41-year-old healthy female presented with one-day abdominal pain, initially periumbilical then localized to the right lower quadrant, with nausea and vomiting. Imaging confirmed acute appendicitis, and laparoscopic appendectomy was performed. Histopathology showed acute inflammation and an incidental serrated polyp confined to the mucosa, without dysplasia or malignancy. The patient recovered uneventfully and was referred for colonoscopy to assess for synchronous colorectal lesions. Routine histopathological evaluation of appendectomy specimens is essential, especially in patients over 40. Incidental serrated polyps, though rare, require further investigation due to their association with colorectal neoplasia. Early detection enables appropriate surveillance and may contribute to colorectal cancer prevention.

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