title: Mucinous borderline tumours of the ovary and the appendix: a retrospective study and overview of the literature.
abstract: OBJECTIVE
  Appendectomy is often recommended in patients with mucinous borderline ovarian tumours (mBOTs) based on studies suggesting that metastatic disease from a primary appendiceal tumour can mimic mBOT. The present study assessed the incidence of mucinous neoplasms in the appendix associated with the presence of mBOT.
  
  
  METHODS
  A retrospective cohort study was performed in two university hospitals in the Netherlands between 1990 and 2011. All patients with mBOT and/or a mucinous appendiceal tumour were included.
  
  
  RESULTS
  Of 127 patients included, 98 had a primary mBOT and 29 had a primary mucinous appendiceal tumour. In patients with a mBOT, the appendix was either removed at prior surgery (4%), resected as part of the staging procedure showing no pathological abnormalities (13%), described as normal and not resected (58%), or not described and not resected (25%). During a median follow-up period of 5 years (range 2-23), two patients developed a recurrence in which the appendix was not involved. In all patients with a primary mucinous tumour of the appendix, the appendix appeared abnormal at the time of surgery. Eight of these patients (28%) were diagnosed with invasive ovarian metastases. A review of the literature including the cases from this study identified 510 mucinous ovarian tumours with borderline features and 214 associated appendectomies, of which 4 (1.9%) contained a primary appendiceal malignancy.
  
  
  CONCLUSIONS
  A thorough inspection of the appendix should be performed in patients with a mucinous ovarian tumour with borderline features. An appendectomy should only be performed when the appendix is macroscopically abnormal.
authors.affiliation: Maastricht University Medical Centre, Department of Obstetrics and Gynecology, Maastricht, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Kleppe
authors.affiliation: Radboud University Nijmegen Medical Centre, Department of Obstetrics and Gynecology, Nijmegen, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Bruls
authors.affiliation: Maastricht University Medical Centre, Department of Obstetrics and Gynecology, Maastricht, The Netherlands; GROW-School for Oncology and Developmental Biology, Maastricht, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: Van Gorp
authors.affiliation: Radboud University Nijmegen Medical Centre, Department of Obstetrics and Gynecology, Nijmegen, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Massuger
authors.affiliation: Maastricht University Medical Centre, Department of Obstetrics and Gynecology, Maastricht, The Netherlands; GROW-School for Oncology and Developmental Biology, Maastricht, The Netherlands.
authors.forename: B F M
authors.initials: BF
authors.lastname: Slangen
authors.affiliation: GROW-School for Oncology and Developmental Biology, Maastricht, The Netherlands; Maastricht University Medical Centre, Department of Pathology, Maastricht, The Netherlands.
authors.forename: K K
authors.initials: KK
authors.lastname: Van de Vijver
authors.affiliation: Maastricht University Medical Centre, Department of Obstetrics and Gynecology, Maastricht, The Netherlands; GROW-School for Oncology and Developmental Biology, Maastricht, The Netherlands.
authors.forename: A J
authors.initials: AJ
authors.lastname: Kruse
authors.affiliation: Maastricht University Medical Centre, Department of Obstetrics and Gynecology, Maastricht, The Netherlands; GROW-School for Oncology and Developmental Biology, Maastricht, The Netherlands. Electronic address: r.kruitwagen@mumc.nl.
authors.forename: R F P M
authors.initials: RF
authors.lastname: Kruitwagen
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000556:secondary* / Q000601:surgery; D001062:Appendectomy; D001063:Appendiceal Neoplasms / Q000473:pathology* / Q000601:surgery; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009426:Netherlands; D010051:Ovarian Neoplasms / Q000556:secondary* / Q000601:surgery; D010052:Ovariectomy; D012189:Retrospective Studies
keywords: Appendix; Borderline tumour of the ovary