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[A carcinoid with cecal localization. Apropos a case]

A Chisari1, M Nicolosi, S Compagnone

  • 1Dipartimento di Chirurgia, Università degli Studi, Catania.

Minerva Chirurgica
|January 1, 1996
PubMed
Summary
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Carcinoid tumors of the large-bowel are rare gastrointestinal tumors with nonspecific symptoms, often diagnosed post-surgery. Radical surgery is key for early-stage carcinoid tumors, while combination therapy offers palliation for advanced cases.

Area of Science:

  • Gastroenterology
  • Oncology
  • Surgical Pathology

Background:

  • Carcinoid tumors represent a small fraction of malignant digestive tumors, with a specific incidence in the large bowel.
  • Diagnosis of large-bowel carcinoid tumors is challenging due to nonspecific clinical presentations.

Observation:

  • A case of a 68-year-old woman with a large-bowel carcinoid tumor highlights diagnostic and therapeutic challenges.
  • The tumor, measuring 7 cm, caused significant lumen narrowing and infiltrated the ileocecal valve, necessitating right hemicolectomy with lymphadenectomy.

Findings:

  • Nonspecific symptoms often lead to diagnosis via postoperative histopathologic analysis.
  • Diagnostic tools include urinary 5-hydroxyindoleacetic acid (5-HIAA) levels, imaging (CT, ultrasonography, angiography), and octreotide scintigraphy for metastasis detection.

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  • Tumor size (<2 cm), localization, serosal penetration, and residual disease are critical prognostic factors.
  • Implications:

    • Radical surgery is the primary treatment for small carcinoid tumors to prevent metastasis.
    • Adjuvant chemotherapy and radiotherapy have limited efficacy; combination therapy with interferon alpha and octreotide is used for palliation in inoperable cases.