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Goblet cell carcinoid tumors (adenocarcinoid) of the appendix

Toumpanakis, Christos, Standish, Richard A., Baishnab, Elora, Winslet, Mark C. and Caplin, Martyn E. 2007, Goblet cell carcinoid tumors (adenocarcinoid) of the appendix, Diseases of the colon and rectum, vol. 50, no. 3, pp. 315-322, doi: 10.1007/s10350-006-0762-4.

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Title Goblet cell carcinoid tumors (adenocarcinoid) of the appendix
Author(s) Toumpanakis, Christos
Standish, Richard A.
Baishnab, Elora
Winslet, Mark C.
Caplin, Martyn E.
Journal name Diseases of the colon and rectum
Volume number 50
Issue number 3
Start page 315
End page 322
Total pages 8
Publisher Lippincott Williams & Wilkins
Place of publication New York, N.Y.
Publication date 2007-03
ISSN 0012-3706
1530-0358
Summary 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.
Language eng
DOI 10.1007/s10350-006-0762-4
Field of Research 111202 Cancer Diagnosis
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ┬ęThe American Society of Colon and Rectal Surgeons
Persistent URL http://hdl.handle.net/10536/DRO/DU:30028224

Document type: Journal Article
Collection: School of Medicine
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