Carcinoid tumors are the most common of all appendix tumors. They are
neuroendocrine tumors, meaning they are tumors that can create and release
hormones into the bloodstream, although this usually only happens with metastatic
disease (carcinoid tumors that have spread beyond the appendix to other areas of
the body). Carcinoids are small yellow tumors usually found in the part
of the appendix farthest away from where the appendix attaches to the colon or
tip of the appendix. The tumors usually do not block the
appendix and cause appendicitis. They are most often found unexpectedly during other
abdominal or pelvic surgeries, for example surgeries to remove the gall bladder, hysterectomy
etc. The tumors are small, slow growing and rarely metastasize
(spread to other areas). The term "malignant" is applied to carcinoids
that have metastasized to other areas of the body.
Carcinoids usually cause no symptoms. Symptoms of
syndrome may rarely
occur with metastasis, especially metastasis to the liver.
Tumors less then 1 cm in
diameter are treated with appendectomy (surgical removal of the appendix)
only. Appendectomy is usually considered 100% curative for these small tumors. Over 95% of
carcinoid tumors of the appendix are less than 2 cm in size.
Tumors 1.5-2 cm
may be treated with appendectomy only or with right hemicolectomy (removal
of up to half of the right side of the colon); there is
disagreement in the medical community in regards to treatment in for
carcinoids this size.
Carcinoids greater than 2
cm are more likely to metastasize. Surgical treatment for these larger
carcinoids is appendectomy, right hemicolectomy (removal of up to half of
the right side of the colon) and removal of
local lymph nodes.
When carcinoid tumors
spread (metastasize), they most commonly spread to the liver or lymph nodes.
Chemotherapy is not very successful in this disease, with 30% limited
response to chemotherapy reported. These metastatic tumors may be
Appendiceal carcinoids are more common in
women by a ratio of 2:1 or 3:1. Average age 4th or 5th decade of life. No
other known risk factor
Overall 5 year survival reported as high as 90% in some medical research
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