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Carcinoid tumour of the appendix

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Background:

Appendiceal carcinoid tumours are found in 0·3–0·9 per cent of patients undergoing appendicectomy. Controversy exists over the management following appendicectomy, especially with regard to the role of right hemicolectomy in patients with tumours smaller than 2 cm in diameter.

Methods and results:

The literature pertaining to the behaviour of appendiceal carcinoids was reviewed in order to formulate indications for right hemicolectomy. Metastatic disease from appendiceal carcinoids is a rare occurrence, but is more common when lesions are larger than 2 cm in diameter. The risk–benefit balance of right hemicolectomy needs to be better defined, and an improved understanding of tumour cell biology may aid prognostic accuracy and decision‐making.

Conclusion:

There is limited evidence on which to base clear indications for right hemicolectomy in patients with a diagnosis of appendiceal carcinoid. Acceptable indications are carcinoids larger than 2 cm in size, any high‐grade malignant carcinoid (including those with a high mitotic index), mesoappendiceal invasion, lesions at the base of the appendix with tumour‐positive margins, and goblet cell adenocarcinoid tumours. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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Document Type: Review Article

Affiliations: 1: University Department of Surgery, Royal Free Hospital and University College London Medical School, London, UK 2: Neuroendocrine Tumour Clinic, Royal Free Hospital, London, UK

Publication date: November 1, 2003

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