İSMAİL SEZİKLİ, MAHMUT ARİF YÜKSEK, HAVVA HANDE KESER ŞAHİN
Anatolian Current Medical Journal - 2025;7(4):465-469
Aims: Surgical interventions for benign conditions are frequently performed in general surgery practice; however, the incidental detection of malignancies in these specimens represents a clinically significant and often overlooked issue. This study aimed to investigate the incidence, pathological characteristics, and follow-up status of incidental malignancies identified in routinely resected specimens, with a particular emphasis on the adequacy of postoperative notification and follow-up processes. Methods: A retrospective cohort study was conducted on 2.590 surgical procedures-appendectomy, cholecystectomy, abdominal wall hernia repair, hemorrhoidectomy, and pilonidal sinus excision-performed between January 1, 2023, and January 1, 2024, at a tertiary care institution. Patients with preoperatively known or radiologically suspected malignancies were excluded. Pathological reports were reviewed for incidental malignant findings, and follow-up data were obtained via electronic health records and direct patient communication. Results: Among the reviewed cases, ten incidental malignancies (0.39%) were identified: eight in appendectomy specimens, one in a cholecystectomy specimen, and one in a hernia sac. Remarkably, 30% of the affected patients were unaware of their pathological diagnosis until they were contacted by the researchers. Significant variability in specimen submission practices, especially in hernia and hemorrhoidectomy cases, may have contributed to underdiagnosis. Conclusion: Although rare, incidental malignancies carry substantial prognostic implications if left unrecognized or inadequately managed. Routine pathological evaluation of all surgical specimens-regardless of presumed benignity-and the implementation of automated alert systems for critical pathology results are essential for timely diagnosis, appropriate referral, and improved patient outcomes.
