Section of Endocrine Surgery, Department of Surgery, University of Wisconsin, Madison, Wisconsin 53792, USA.
J Surg Res. 2013 Sep;184(1):183-8. doi: 10.1016/j.jss.2013.05.107. Epub 2013 Jun 21.
Extra-appendiceal colonic carcinoids are uncommon neuroendocrine tumors with a poor prognosis compared with carcinoids of other gastrointestinal origins. Few studies have examined the clinicopathologic profile and behavior of this rare tumor.
A retrospective analysis was performed on patients with colonic carcinoid tumors evaluated at a single tertiary care center between 1996 and 2012. Collected data included patient and tumor characteristics, presentation, treatment, recurrence, and survival. Results were integrated into a comprehensive review of the colonic carcinoid literature.
In total, 114 patients with colorectal carcinoid tumors were identified, and 15 patients with extra-appendiceal tumors were analyzed. The mean age was 58.6 ± 3.0 y, and subjects were predominantly male (73.3%). The most common presenting problem was abdominal pain (33.3%), although 26.7% of patients were asymptomatic. Cecal tumors were the most prevalent (73.3%), and most patients underwent right hemicolectomy. Three patients with lesions < 1 cm were treated endoscopically. The mean tumor diameter was 2.9 ± 0.5 cm, with lymph node or distant metastasis present in 53.3% and 26.7%, respectively. All but two patients underwent a presumed curative resection. During a mean follow-up of 4.2 ± 1.0 y, there was only one death (non-carcinoid specific). Eleven patients were alive without evidence of disease at last follow-up and three patients were alive with disease, one of whom initially had a presumed curative resection that recurred.
This case series further elucidates the clinicopathologic characteristics of colonic carcinoid tumors, which aids physicians in guiding the diagnosis and management of these rare tumors.
阑尾外结肠类癌是一种罕见的神经内分泌肿瘤，与其他胃肠道来源的类癌相比，预后较差。很少有研究检查过这种罕见肿瘤的临床病理特征和行为。
对 1996 年至 2012 年期间在一家三级保健中心评估的结肠类癌肿瘤患者进行了回顾性分析。收集的数据包括患者和肿瘤特征、表现、治疗、复发和生存情况。结果被整合到对结肠类癌文献的综合回顾中。
总共确定了 114 例结直肠类癌肿瘤患者，其中分析了 15 例阑尾外肿瘤患者。平均年龄为 58.6 ± 3.0 y，患者主要为男性（73.3%）。最常见的首发症状是腹痛（33.3%），尽管 26.7%的患者无症状。盲肠肿瘤最为常见（73.3%），大多数患者接受了右半结肠切除术。3 例<1 cm 的病变接受了内镜治疗。肿瘤平均直径为 2.9 ± 0.5 cm，分别有 53.3%和 26.7%的患者有淋巴结或远处转移。除了两名患者外，所有患者都进行了假定的根治性切除。在平均 4.2 ± 1.0 y 的随访期间，只有一名患者死亡（非类癌特异性）。11 名患者在最后一次随访时无疾病存活，3 名患者仍患有疾病，其中 1 名患者最初接受了假定的根治性切除后复发。
本病例系列进一步阐明了结肠类癌肿瘤的临床病理特征，有助于医生指导这些罕见肿瘤的诊断和治疗。
