Colorectal carcinoid tumors - own experience

Symptomatology, diagnostics and treatment problems in 5 patients with color ectal carcinoid are presented. From 1974 to 1999 in the Clinic of Endocrino logical and General Surgery of the Medical University of Lodz, 3001 patient s underwent surgery due to acute appendicitis and 431 for colorectal cancer . Among them, there were 5 patients in whom the histological examination re vealed colorectal carcinoid. The carcinoids were localized in the appendix in 4 patients and in the left colon flexure in 1 patient. The mean age of t hese 5 carcinoid patients at the time of diagnosis was 38.4 years (range 18 -72 yr). The female-to-male ratio amounted to 4:1. The symptoms of all 5 patients was not typical for carcinoid of the colon. In four surgery was performed for acute appendicitis and one patient compla ined of chronic obstipation and pain in the left epi- and mesogastrium. The double-contrast examination of the large intestine revealed tumor of the l eft colon flexure. Four carcinoid patients with the signs of acute appendicitis had emergency surgery. The carcinoid tumors were diagnosed microscopically after surgery only. In 3 of them the tumor extended beyond the appendix and a reoperation was performed. In one patient with the tumor of small diameter (5 mm) invo lving only the mucosa and submucosa a reoperation was not indicated. In 3 r eoperated patients right hemicolectomy with regional lymphadenectomy was pe rformed. The patient with the tumor of the left colon flexure diagnosed pre operatively underwent radical surgery with regional lymphadenectomy. The po stoperative histological examination of the tumor confirmed carcinoid. No c arcinoid metastases were found in lymph nodes of all studied cases. Until today, all 5 carcinoid patients are alive with no signs of local recc urrence or distant metastases over the 1-20 year follow-up period.