A detailed analysis of appendiceal neoplasms, highlighting how management is strictly driven by histology and classification. For invasive adenocarcinoma, a formal right hemicolectomy (RHC) is the standard due to the high risk of nodal metastasis (up to 30%). For mucinous neoplasms (LAMN/HAMN), the management pivots away from RHC to aggressive surveillance, driven by the critical distinction between high-risk cellular mucin versus low-risk acellular mucin found outside the appendix. For Neuroendocrine Tumors (ANENs), RHC is mandatory for lesions > 2 cm, or those 1-2 cm with high-risk features like lymphovascular invasion or involvement of the base. Finally, the episode stresses the fundamental reclassification of Goblet Cell Carcinoma (GCC) as a highly aggressive adenocarcinoma, requiring RHC and corresponding surveillance protocols.
