Appendiceal cancer is a relatively uncommon condition that develops in the appendix, a small tube-like organ attached to the first part of the colon (cecum). In many cases, appendiceal cancer begins as a small, benign growth in the appendix (mucocele), which can progress and become cancerous over time.

There are currently no screening tests for appendiceal cancer. In many cases, the symptoms are nonspecific, such as abdominal pain, bloating and changes in bowel habits. Sometimes, the condition is detected during a diagnostic test performed for an unrelated reason, such as suspected appendicitis.

Treatment for appendiceal cancer typically involves surgery to remove the appendix and a margin of surrounding healthy tissue (appendectomy). Depending on the type and stage of the tumor, additional treatments such as chemotherapy or radiation therapy may be considered.

As with any type of cancer, an early diagnosis of appendiceal cancer is the key to achieving the best possible outcome and quality of life. The diagnostic process may include:

Laboratory tests used for diagnosing appendiceal cancer

If appendiceal cancer is suspected based on a medical history review, symptom evaluation and physical examination, a physician may order lab testing, such as:

Blood work

Blood testing may show elevated levels of certain markers, such as carcinoembryonic antigen (CEA) or CA 19-9, which are associated with some types of cancer, including appendiceal cancer.

Urinalysis

Although urinalysis is not used to diagnose appendiceal cancer, it can provide valuable clues about the patient’s kidney function and overall health, which a physician may use to guide treatment decisions.

Imaging tests used for diagnosing appendiceal cancer

During the diagnostic process, a physician may order imaging tests to evaluate the location, size and extent of an appendiceal tumor. Some options include:

Ultrasound

After applying a special gel to the abdomen, an ultrasound technician will glide a handheld device (transducer) across the skin, generating high-frequency sound waves and sending them into the body. The sound waves will bounce off the internal organs and tissues, creating images that can be viewed on a nearby monitor. Ultrasound imaging can help a physician identify an enlarged or abnormal-looking appendix, which may indicate the presence of a tumor and warrant follow-up testing.

Computed tomography (CT)

During a CT scan, an X-ray beam continually moves around the body, capturing multiple images from various angles. The X-ray information is then processed by a computer to create detailed cross-sectional images of structures in the abdomen and pelvis, including the appendix.

Magnetic resonance imaging (MRI)

During an MRI scan, the patient lies on a special table that slides into a cylindrical machine, where radio waves and a powerful magnet will be used to create detailed cross-sectional images of the abdomen and pelvis. The images can help a physician evaluate the size and spread of any tumors in the appendix.

Positron emission tomography (PET)

Before a PET scan, a small amount of radioactive tracer will be injected into the bloodstream.

Because cancerous cells typically have a higher metabolic rate than healthy cells, they will absorb more of the tracer. The tracer will emit positrons, which can be detected by a PET scanner and used to create detailed images of the body’s internal structures. A PET scan can help a physician evaluate the extent of appendiceal cancer and determine whether it has spread to other parts of the body.

Procedure used for diagnosing appendiceal cancer

The main diagnostic procedure for appendiceal cancer is:

Biopsy

A biopsy involves removing a sample of suspicious tissue for microscopic examination by a pathologist, who can identify cancer cells. If appendiceal cancer is suspected based on the symptoms or imaging tests, a biopsy usually involves removing the entire appendix (appendectomy). Alternatively, a thin needle may be used to extract a small sample of tissue from the appendix.

Biopsy is the most definitive way to diagnose appendiceal cancer.

Benefit from world-class care at Moffitt Cancer Center

If you would like to learn more about the diagnostic process for appendiceal cancer, you can request an appointment with a specialist in Moffitt’s renowned Gastrointestinal Oncology Program by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.

Diagnosis