Appendiceal neuroendocrine neoplasms in children and adolescents – Two case reports from a tertiary care center in coastal India

Appendiceal neuroendocrine neoplasms (ANENs) are uncommon in children and adolescents and are incidentally diagnosed in 0.3% of appendicectomy specimens. Pediatric ANENs rarely metastasize and have excellent prognosis. We report two cases of ANENs in adolescents who presented clinically and radiologically with features of acute appendicitis for which they underwent appendicectomy. On gross examination, ≤ 2 cm lesion was identified in both the appendix. Microscopic and immunohistochemical analysis clinched the diagnosis of ANENs. Patients were followed up for 18 months and were disease free. This report emphasizes that a possibility of ANEN should be kept as a differential diagnosis even in the pediatric population presenting with acute appendicitis. A routine histopathological examination of all appendicectomy specimens is therefore crucial, as early diagnosis is associated with excellent prognosis.