Appendiceal Carcinoid Tumors

Carcinoid tumors are the most commonly occurring cancer of the appendix. Appendiceal carcinoids are most often diagnosed in the 4th and 5th decade of life. The relatively young age at which appendiceal carcinoids have been detected may in part be due to the fact that appendectomies are performed most often in young adults. Size is the best predictor of prognosis in patients with appendiceal carcinoid tumors. Over 95% of appendiceal carcinoids are less than 2 cm in size. Metastases are extraordinarily uncommon in such tumors, and simple appendectomy is nearly always curative. In contrast, approximately one third of patients with tumors greater than 2 cm will have either nodal or distant metastases.

The optimal surgical approach to appendiceal carcinoid tumors has been inferred retrospectively from surgical series. Tumors measuring less than 2 cm are generally treated with simple appendectomy in the absence of gross evidence of local spread. Most tumors measuring greater than 2 cm are treated with right colectomy, since local recurrences following a simple appendectomy, though uncommon, may occur.

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