Carcinoid Tumor of Appendix

Carcinoid Tumor of  Appendix

The word Carcinoid means ‘carcinoma like appearance’.

 In the the small bowel Carcinoid tumors arise from Kulchistsky cells located in the crypts of Lieberkuhn.

Kulchistsky cells are also called Argetaffin cells as these cells can be stained by the silver compounds.

Usual age group of Carcinoid Tumor  : Fifth/Sixth Decade of Life

The Most Common Siteof Carcinoid Tumor  : Appendix

Vermiform Appendix

Other Sites of G I Carcinoid Tumor  : Small Intestine, Rectum, Colon, Stomach

Non Intestinal sites of Carcinoid Tumor  : Lungs, Pancreas, Thymus, Ovary, Testis, Biliary tract

Embryologic Classification of Carcinoids

1.     Foregut Carcinoids-Lungs, Stomach & Pancreas

2.     Midgut Carcinoids-Small Intestine & Appendix

3.     Hindgut Carcinoids-Colon & Rectum

Carcinoid Syndrome

• Seen in 10% of cases of
• Due to release of ,Serotonin, Histamine, Bradykinin, Prostaglandin
• Clinical features : Flushing, Watery Diarrhea, Sweating, Wheezing, Breathlessness, Abdominal pain and Hypotension.

Investigations

Urinary 5-HIAA, Chromogranin A

CT Scan Abdomen

CT Scan Chest-for Bronchial Carcinoids

Treatment of Carcinoid Tumor Appendix

If the Carcinoid Tumor Appendix is less than 2 cm and is away from the base, the treatment is Appendicectomy.

Open Appendicectomy

If the Carcinoid Tumor Appendix is close to the base of the appendix or the size is more than 2cm the treatment is Right Hemi Colectomy.

What is Carcinoid Crisis?

Life threatening form of Carcinoid syndrome.

Usually precipitated by Anesthesia, Surgery, Chemotherapy

Prophylactic agent used prevent Carcinoid crisis is Octreotide ( Somatostatin Analogue)