Sessile serrated adenoma of appendix

Purpose: Sessile serrated adenoma of the appendix is rarely seen as a cause of acute appendicitis. These premalignant lesions of the appendix, which cannot be detected by preoperative imaging and tests, can be definitively diagnosed by histopathological examination. This study aims to evaluate the diagnosis and management of sessile serrated adenoma. Methods: The patients underwent surgey due to the diagnosis of acute appendicitis between December 2014 and December 2018 were evaluated retrospectively. Seven patients' postoperative histopathological reports were compatible with sessile serrated adenoma of the appendix. Each patient's presenting symptoms, laboratory tests, imaging methods, type of surgical procedure, length of hospital stay, postoperative mortality and morbidities, postoperative colonoscopy reports were recorded. Results: The patient's median age was 48 (29-72) years. Three of the patients were male, and four were female. All the patients were diagnosed as acute appendicitis and operated with an open technique under general anesthesia. Postoperative mortality and morbidity weren't seen in patients. All appendectomy specimens which were compatible with sessile serrated adenoma were evaluated carefully for invasion and carcinoma. Two months after the surgery, colonoscopy was performed to all patients. Although four patient's colonoscopies were unremarkable, three of the patient's colonoscopies were reported as tubular adenoma with low-grade dysplasia in descending and sigmoid colon. Conclusion: The diagnosis, treatment and postoperative follow-up require more careful evaluation for sessile serrated adenoma of the appendix. Postoperative colonoscopy recommended due to the possibility of a high risk of sessile serrated adenoma or carcinoma in the rest of the colon.