Appendiceal neuroma presented as acute appendicitis: A rare case report from Syria

INTRODUCTION AND IMPORTANCE: Appendiceal neuroma, also known as fibrous obliteration, is an exceptional benign lesion discovered in the vermiform appendix removed for indications of acute appendicitis. CASE PRESENTATION: We report a case of a 76-year-old woman who presented with signs and symptoms of acute appendicitis. An abdominal ultrasound revealed a mildly distended appendix with a peri-appendiceal fluid collection. Gross examination of the excised appendix showed an obliterated lumen of the distal part on serial cuts. Microscopically, the lumen is replaced by the proliferation of spindle cells into fascicles embedded in fibrous tissue. The diagnosis of appendiceal neuroma was reported and supported by the result of the S-100 immunohistochemical staining. CLINICAL DISCUSSION: An appendiceal neuroma represents an incidental finding in appendices excised for other reasons. Clinically, there are no specific signs or symptoms, and it is discovered inadvertently. Occasionally, it can mimic acute appendicitis. This lesion is characterized by the proliferation of spindle cells that occlude the lumen of the appendix. CONCLUSION: A histopathological evaluation is essential to achieve a definitive diagnosis of an appendiceal neuroma.