Best management of carcinoid tumor of appendix which is less than 2 cms in size, no involvement of the caecal wall or regional lymphatic spread
Ans. is 'a' i.e., Appendicectomy * Preferred treatment for the carcinoid tumor of appendix which is less than 2 cms in size, no involvement of the caecal wall or regional lymphatic spread is appendicectomy.Carcinoid tumour Of Appendix (synonym: argentaffinoma)* Carcinoid tumours arise in argentaffin tissue (Kulchitsky cells of the crypts of Lieberkiihn) and are most common in the vermiform appendix.* In many instances, the appendix had been removed because of symptoms of subacute or recurrent appendicitis.* The tumour can occur in any part of the appendix, but it is frequently found in the distal third.* The neoplasm feels moderately hard and, on sectioning the appendix, it can be seen as a yellow tumour between the intact mucosa and the peritoneum.* Microscopically, the tumour cells are small, arranged in small nests within the muscle and have a characteristic pattern using immunohistochemical stain for chromogranin B.* Unlike carcinoid tumours arising in other parts of the intestinal tract, carcinoid tumour of the appendix rarely gives rise to metastases.* Appendicectomy has been shown to be sufficient treatment, unless the caecal wall is involved, the tumour is 2 cm or more in size or involved lymph nodes are found, when right hemicolectomy is indicated.
Appendicectomy
Right hemicolectomy
Colostomy
Chemoradiation
Vermiform Appendix