Adenocarcinoid of the Appendix (Goblet Cell Carcinoid)

Adenocarcinoid tumors of the appendix are also called Goblet Cell Carcinomas or Crypt Cell Carcinomas. These tumors share features of both adenocarcinoma and carcinoid types of appendix tumors. Adenocarcinoid tumors are more likely to metastasize (spread to other areas) than carcinoid tumors of the appendix. Approximately 20% of these tumors metastasize into the peritoneal cavity (the inside of the abdomen). In females, 90% of adenocarcinoid tumors that metastasize spread to to the ovaries. In rare cases, adenocarcinoid tumors can produce mucous and can cause a condition called "mucinous peritoneal carcinomatosis" , which means widespread growth of mucous-producing cancerous tumors in the abdomen (see Mucinous Tumors).

Symptoms:

The most common first symptom is appendicitis. In other cases the cancer is most often discovered unexpectedly when the patient is undergoing another surgical procedure.

Treatment:

For tumors less than 2 cm that have not spread to the lymph nodes or other areas, appendectomy only (surgical removal of the appendix) is all that is recommended in some medical literature
For tumors at the base of the appendix (near where the appendix attaches to the right side of the colon), spread to lymph nodes or tumor size greater than 2 cm, appendectomy with right hemicolectomy (removal of all or part of the right side of the colon) is the preferred surgical treatment.
Some literature recommends removal of the ovaries during surgery to prevent them from possibly becoming cancerous later, as this cancer commonly spreads to the ovaries.
tumors that metastasize into the peritoneum (spread to the inside of the abdomen) may be treated with cytoreduction surgery and peritoneal chemotherapy
in some cases with metastasis, intravenous (IV) chemotherapy is used, with some medical research reporting a 50% response of adenocarcinoid tumors to the Folfox chemotherapy combination.
in cases of mucous-producing tumors with mucinous peritoneal carcinomatosis (widespread mucous-producing tumors in the abdomen), recommendation has been treatment with cytoreduction (debulking) surgery and intraperitoneal chemotherapy.

Risk Factors:

Occurs equally in men and women, mean age of occurrence 58.9 years of age. No other risk factors were identified in the literature.

Prognosis:

5 year survival rates noted in literature between 60 and 84%. Some literature states 60% ten year survival. Extensive spread of goblet cell carcinoid (adenocarcinoid) into the abdomen is unusual, but when it follows this course, overall 5-year survival is approximately 25% in medical literature.

Surgical and chemotherapy treatment outcomes of goblet cell carcinoid: a tertiary cancer center experience.

Goblet Cell Carcinoid of the Appendix

Surgical and chemotherapy treatment outcomes of goblet cell carcinoid: a tertiary cancer center experience.

Adenocarcinoid of the appendix vermiformis: complete and persistent remission after chemotherapy (folfox) of a metastatic case.

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Last Updated 05/05/2008 12:17:23 PM