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A Journal on Surgery

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Chirurgia 2005 October;18(5):385-8

language: Italian

Carcinoid of the appendix: three cases

Coli P.


Three cases of appendix carcinoid has been observed in our hospital in the last eight years. We took this remark as starting point for an examination of diagnostic and therapeutic approach of this rare disease. The appendix localitation is one of more frequent. Appendix carcinoid is more frequent in women and is frequently located at he tip of appendix. Preoperatory diagnosis is rare. It is diagnosed incidentally by antomopatologus after an operation for acute appendicitis. The disease isn't in all cases benign. Hepatic mts can be presented even if are rare (<2% all cases) and sometimes classic ''carcinoid syndrome'' with diarrea, bronchoconstriction, cardiac valve disease, flush. Surgery is the best therapeutic approach: simple appendectomy is adeguate treatment for appendiceal carcinoid less than 1 cm, right hemicolectomy for those greater than 2 cm. We observed two cases of appendiceal carcinoid less than 1 cm diameter treated with simple appendectomy. In a case the neoplasm had a 2 cm diameter so we have eseguited a right emicolectomy. Dimension, localitation, mesoappendiceal invasion, hepatic mts are negative prognostic factors. Patient follow-up must be accurated and must be include routine examination (ematokimic, abdomen eco and CT, acido idrossi indoloacetico, cromogranina A and enolasi neurospecifica valutation, sintetic similar of serotonina (octreotide ) scintigraphy). With this therapeuthic approach and with meticulous follow-up appendiceal carcinoid has a good prognosis with a five year survival rate of 85-100%. Octreotide seem increase survival in patients with hepatic mts. We marked the importance of making histologic examination on all asported appendiceal because appendiceal carcinoid are found in a case on 200-300 appendiceal examinated.

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