Celi D, Scuderi G, Battaglino D, Lupi A, Dramissino M I
Unità Operativa di Chirurgia Generale, Azienda Sanitaria ULSS 3, Regione Veneto.
Minerva Chir. 1999 Mar;54(3):175-8.
Carcinoid tumors arise from neuroendocrine system and one of their preferred sites is the appendix. Most of appendiceal carcinoids almost always are clinically silent and are incidentally found at histological examination. For this reason, histological examination of the appendix is recommended in every case of the appendicectomy. Prognostic factors are: tumor stage, histologic pattern and differentiation. The authors present 6 cases of appendiceal carcinoid tumor, clinically silent and found at histologic examination (3 cases of appendicectomy for acute appendicitis, 3 cases of appendicectomy associated with abdominal surgical interventions for other pathology) and compare their experience with the most recent literature on this subject. The conclusion is drawn that the size of this tumor is the main factor that surgeons must consider for the choice of surgical treatment. Incidental, clinical silent, small (less than 2 cm in size) appendiceal carcinoid tumors can be treated by appendicectomy, and they do not need follow-up. Greater (more than 2 cm in size) appendiceal carcinoid tumors, in young patients must be treated with a right hemicolectomy and they need follow-up (periodically radiological, ultrasonographic and endoscopic examinations, tumor markers) because there is the possibility of recurrence or metastases.
类癌肿瘤起源于神经内分泌系统,其好发部位之一是阑尾。大多数阑尾类癌在临床上几乎总是无症状的,多在组织学检查时偶然发现。因此,在每例阑尾切除术中都建议进行阑尾组织学检查。预后因素包括:肿瘤分期、组织学类型和分化程度。作者报告了6例阑尾类癌肿瘤病例,这些病例临床上无症状,均在组织学检查时发现(3例因急性阑尾炎行阑尾切除术,3例因其他病理情况在腹部手术干预时行阑尾切除术),并将他们的经验与该主题的最新文献进行了比较。得出的结论是,肿瘤大小是外科医生选择手术治疗时必须考虑的主要因素。偶然发现的、临床上无症状的、较小(直径小于2厘米)的阑尾类癌肿瘤可通过阑尾切除术治疗,无需随访。较大(直径大于2厘米)的阑尾类癌肿瘤,对于年轻患者必须行右半结肠切除术,且需要随访(定期进行影像学、超声和内镜检查、肿瘤标志物检查),因为存在复发或转移的可能性。