title: Appendiceal pathology at the time of oophorectomy for ovarian neoplasms.
abstract: OBJECTIVE
  To investigate the prevalence of appendiceal pathology in women undergoing surgery for a suspected ovarian neoplasm and the predictive value of intraoperative findings to determine the need for appendectomy at the time of surgery.
  
  
  METHODS
  Retrospective analysis of patients who underwent oophorectomy and appendectomy during the same surgical procedures at the University of Virginia Health System from 1992 to 2007. Observations were stratified based on the nature (benign, borderline, or malignant) and histology (serous compared with mucinous) of the ovarian neoplasm, frozen compared with final pathological diagnosis, and the gross appearance of the appendix.
  
  
  RESULTS
  Among the 191 patients identified, frozen section was consistent with seven mucinous and 35 serous carcinomas, 16 serous and 33 mucinous borderline tumors, 71 mucinous and serous cystadenomas, and 29 cases of suspected metastatic tumor from a gastrointestinal primary. The highest rates of coexisting appendiceal pathology were associated with serous ovarian cancers (94.4% of grossly abnormal and 35.3% of normal appendices) and ovarian tumors suspected to be of primary gastrointestinal origin (83.3% grossly abnormal and 60.0% normal appendices harbored coexisting mucinous neoplasms). Linear regression analysis revealed that appearance of the appendix and frozen section diagnosis of the ovarian pathology were statistically significant predictors of coexisting appendiceal pathology, but the latter was more important.
  
  
  CONCLUSIONS
  The prevalence of coexisting, clinically significant appendiceal pathology is low with a frozen section diagnosis of serous or mucinous cystadenoma. Appendectomy is recommended when frozen section diagnosis is mucinous or serous ovarian carcinoma, borderline tumor or metastatic carcinoma of suspected gastrointestinal origin.
authors.affiliation: From the W. Norman Thornton Division of Gynecologic Oncology Department of Obstetrics and Gynecology and the Department of Pathology, University of Virginia Health System, Charlottesville, Virginia.
authors.forename: Julia
authors.initials: J
authors.lastname: Timofeev
authors.forename: Mary T
authors.initials: MT
authors.lastname: Galgano
authors.forename: Mark H
authors.initials: MH
authors.lastname: Stoler
authors.forename: Jason A
authors.initials: JA
authors.lastname: Lachance
authors.forename: Susan C
authors.initials: SC
authors.lastname: Modesitt
authors.forename: Amir A
authors.initials: AA
authors.lastname: Jazaeri
mesh_terms: D000328:Adult; D001062:Appendectomy; D001063:Appendiceal Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery; D001065:Appendix / Q000473:pathology; D002429:Cecal Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005629:Frozen Sections; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications / Q000601:surgery*; D010052:Ovariectomy