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Goblet Cell Carcinoid Tumors (Adenocarcinoid) of the Appendix

  • Published:
Diseases of the Colon & Rectum

Purpose

Goblet cell appendiceal carcinoids represent rare tumors that exhibit histologic features of both adenocarcinomas and neuroendocrine tumors. We present the long-term results of a series of 15 patients, focusing on clinical manifestations, diagnosis, and management.

Methods

Eight male and seven female patients (median age, 52.8 years) were included. Final diagnosis was confirmed by histology. Patients were evaluated clinically, biochemically, and radiologically every four months. Median follow-up was 30 months.

Results

The majority of patients (7/15) presented with symptoms compatible with acute appendicitis. Right hemicolectomy was performed in all except one, who subsequently developed metastases. Three patients had metastases at previous diagnosis. Plasma chromogranin-A was slightly elevated in two of them, while urinary 5-hydroxy-indol-acetic acid was normal. 111Indium-labeled octreotide scintigraphy was positive only in two of the four patients with metastases. Ki67 index was greater than 20 percent in all of them, while in only one with local tumor. Combination chemotherapy with either cisplatin plus etoposide or with 5-fluorouracil, cisplatin, and streptozotocin was administered to all patients with metastases resulting in temporary stabilization of disease. Twelve patients are alive, while three died of their disease 9, 13, and 14 months after diagnosis.

Conclusions

The diagnostic value of chromogranin-A, urinary 5-hydroxy-indol-acetic acid, and 111Indium-labeled octreotide scintigraphy seems to be limited in these tumors. Ki67 index appears to predict tumor behavior. Right hemicolectomy may reduce the risk of developing metastases. Chemotherapy may have efficacy in metastatic disease, however, more data are required to determine this and the optimal regimen.

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Authors and Affiliations

  1. Neuroendocrine Tumour Unit, Centre for Gastroenterology, Royal Free Hospital, London, NW3 2QL, United Kingdom

    Christos Toumpanakis M.D., Ph.D., Elora Baishnab M.B. & Martyn E. Caplin B.S., D.M. (Hons.), F.R.C.P.

  2. Department of Histopathology, Royal Free Hospital, London, United Kingdom

    Richard A. Standish M.R.C.Path.

  3. University Department of Surgery, Royal Free Hospital and University College London Medical School, London, United Kingdom

    Mark C. Winslet M.S., F.R.C.S.

Authors
  1. Christos Toumpanakis M.D., Ph.D.
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  2. Richard A. Standish M.R.C.Path.
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  3. Elora Baishnab M.B.
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  4. Mark C. Winslet M.S., F.R.C.S.
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  5. Martyn E. Caplin B.S., D.M. (Hons.), F.R.C.P.
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Corresponding author

Correspondence to Martyn E. Caplin B.S., D.M. (Hons.), F.R.C.P..

Additional information

Dr. Christos Toumpanakis is supported by a grant from the Hellenic (Greek) Society of Gastroenterology.

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Toumpanakis, C., Standish, R.A., Baishnab, E. et al. Goblet Cell Carcinoid Tumors (Adenocarcinoid) of the Appendix. Dis Colon Rectum 50, 315–322 (2007). https://doi.org/10.1007/s10350-006-0762-4

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  • DOI: https://doi.org/10.1007/s10350-006-0762-4

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