25 year old patient presented with mass in . iliac fossa, which after laparotomy was found to be carcinoid of 2.5 cm in diameter. What will be the next step in management?
Appendicectomy is the treatment of choice in appendiceal carcinoids < 1 cm in size and tumor size 1-2 cm located at the tip. Rt hemi colectomy is indicated when: Tumor is >2 cm in size Tumor of size 1-2 cm involving base of appendix Tumor of size 1-2 cm involving caecal wall or mesoappendix. Lymph nodes are involved (metastasis present). Also know Treatment for carcinoids of small intestine Carcinoid < 1cm in situ --------- segmental small bowel resection Carcinoid > 1cm in size or multiple tumors or regional lymph node metastasis ------ wide excision of bowel along with its mesentery. Carcinoid of terminal ileum-------- . hemicolectomy Ref: Sabiston 18/e, Page 1345; Schwaz 9/e, page 1088; bailey & Love 24/e, Page 1217.
Segmental resection
Rt. hemicolectomy
Appendicectomy
Do yearly 5 HIAA assay