Saylam B, Küçük Ö K, Düzgün A P, Özer M V, Coşkun F
Ankara Numune Teaching and Research Hospital, 3. General Surgery, 53. cadde 35/10 Kızılırmak Mah, Çankaya, Ankara, Turkey.
Eur J Trauma Emerg Surg. 2011 Oct;37(5):491-3. doi: 10.1007/s00068-010-0066-1. Epub 2010 Dec 17.
To conduct a retrospective analysis of the incidence and long-term outcomes of carcinoid tumor of the appendix in emergency appendectomies.
From a histopathologic database of 2197 appendectomies from a single center, all appendiceal carcinoid tumors were identified and case notes reviewed. Demographic data, clinical presentation, histopathology, operative reports, and survival were scored and compared with those reported in the literature.
Ten patients (0.45%) with appendiceal carcinoid tumor were identified (2 male, 8 female; mean age, 29.2 years; age range, 14-56 years). In all cases, the clinical presentation resembled the symptoms of acute appendicitis. Open appendectomy was performed in all patients. All tumors were located at the tip of the appendix, with a mean diameter of 0.4 cm (range, 0.1-0.9 cm), and the mesoappendix was invaded in one patient. No patient had repeat surgery after the initial operation. After a mean follow-up period of 55 months (range, 26-82 months), all patients were alive and disease- and symptom-free.
To conclude, carcinoid tumors are extremely rare, and the diagnosis is often made after surgery. We emphasise the value of obtaining histopathological analysis of every removed appendix because visual examination does not always correlate with later pathological examination. Furthermore, small appendiceal carcinoids (<1 cm) have an excellent prognosis after appendectomy.
对急诊阑尾切除术中阑尾类癌肿瘤的发病率及长期预后进行回顾性分析。
从单一中心的2197例阑尾切除术的组织病理学数据库中,识别出所有阑尾类癌肿瘤并查阅病例记录。对人口统计学数据、临床表现、组织病理学、手术报告及生存率进行评分,并与文献报道的结果进行比较。
共识别出10例阑尾类癌肿瘤患者(0.45%)(男性2例,女性8例;平均年龄29.2岁;年龄范围14 - 56岁)。所有病例的临床表现均类似急性阑尾炎症状。所有患者均行开腹阑尾切除术。所有肿瘤均位于阑尾尖端,平均直径0.4 cm(范围0.1 - 0.9 cm),1例患者的阑尾系膜受侵。初次手术后无患者接受再次手术。平均随访55个月(范围26 - 82个月)后,所有患者均存活,无疾病且无症状。
总之,类癌肿瘤极为罕见,诊断通常在手术后做出。我们强调对每例切除的阑尾进行组织病理学分析的价值,因为肉眼检查结果并不总是与后续病理检查结果相符。此外,阑尾小类癌(<1 cm)在阑尾切除术后预后良好。