Problems in the management of the appendiceal carcinoid tumors.

Abstract

Abstract

Introduction :

Carcinoid tumors are the most common type of neuroendocrine tumors. Appendix is one of the most common place for carcinoid tumors. Appendectomy may be performed without mesoappendix excision sometimes by surgeons in general practice. In this condition, what happens, if diagnosis is carcinoid tumor. In our series this condition and other carcinoid cases are discussed.

Methods:

Carcinoid tumor cases who were operated between 2002-2010 years are examined retrospectively. Average age, female-male ratio, location of the tumor, invasion of the mesoappendix, inflammatory changes, management of the cases are discussed.

Results:

The carcinoid cases number was 6(0,29%). Average tumor size was     (0,2-1,4)cm. All of the cases have not clinical sign of carcinoid syndrome. In one case microinvasion was seen in periappendiceal fatty tissue at the side of mesoappendix. But mesoappendiks had not been removed in the operation so lymphadenopathy was not evaluated by the pathologist.

Conclusion:

The carcinoid syndrome is diagnosed  biochemically. ıf the tumor is greater than 1cm in diameter or is in the base of the appendix or if there is evidence of nodal metastases, a right hemicolectomy is recommended.In five cases appendectomy was enough but one case having mesomicroinvasion was evaluated MR, colonoscopy, octreotid scintigraphy and biochemical tests. The case was not performed extended resection. The case followed over one year and no any sign is found.

Key words: acute abdomen, appendicitis, carcinoid syndrome, carcinoid tumors, neuroendocrine tumor,