Patients with complicated appendicitis show a 16.1% rate of appendiceal neoplasms, necessitating careful evaluation before surgical intervention.

• Among 387 complicated appendicitis cases, 304 had surgery; the majority (78.6%) were surgically treated.
• Neoplasm rates varied: mucocele cases saw the highest at 58%, while perforated appendicitis was at 12%.

Consider age, appendiceal diameter, and lymphadenopathy when assessing surgical options.

• Key predictors of neoplasm included older age, larger appendiceal size, and absence of fat-stranding.