Medline ® Abstracts for References 59,62
of 'Cancer of the appendix and pseudomyxoma peritonei'
Surgical and chemotherapy treatment outcomes of goblet cell carcinoid: a tertiary cancer center experience.
Pham TH, Wolff B, Abraham SC, Drelichman E
Ann Surg Oncol. 2006;13(3):370. Epub 2006 Jan 30.
BACKGROUND: Goblet cell carcinoid (GCC) is a rare malignant tumor with distinct histological and clinical features. Our goals were to review the surgical and chemotherapy outcomes of patients with GCC.
METHODS: We performed a retrospective review of the Mayo Clinic database from 1984 to 2004 with a prospective follow-up of 57 patients with GCC.
RESULTS: The age at diagnosis (mean +/- SE) was 55 +/- 13 years. The most common presentations were right lower quadrant pain mimicking appendicitis (70%) and right lower quadrant or pelvic mass (25%). Only patients with T4 lesions had positive mesenteric nodes, with a frequency of 28%. Fifty percent of female patients had metastasis to the ovaries. The disease-specific 5-year survivals for stages I, II, III, and IV were 100%, 76%, 22%, and 14%, respectively; the overall mean survival was 47 +/- 3 months. All stage I patients had simple appendectomy. The overall 5-year survival rates for patients with combined stages II to IV who underwent appendectomy versus right hemicolectomy were 43% and 34%, respectively (P = .604). The corresponding survival rates foradjuvant chemotherapy versus no chemotherapy were 32% and 27%, respectively (P = .151).
CONCLUSIONS: The prognosis for patients with GCC tumors correlates well with the American Joint Committee on Cancer stage at initial presentation. Appendectomy alone seems adequate for stage I disease. For staging purposes, right hemicolectomy is appropriate for T4 tumors or stage II to III disease provided that it can be performed with minimal risk. Surgical debulking is a consideration but is controversial. Adjuvant chemotherapy with 5-fluorouracil and leucovorin regimen is minimally effective against GCC.
Department of Colorectal Surgery, Mayo Clinic, 200 First Street S.W., Rochester, Minnesota 55905, USA.
Krukenberg tumor from an occult appendiceal adenocarcinoid: a case report and review of the literature.
Mandai M, Konishi I, Tsuruta Y, Suginami N, Kusakari T, Iwasaki T, Fujii S
Eur J Obstet Gynecol Reprod Biol. 2001;97(1):90.
Appendiceal neoplasms with ovarian metastasis are rare. A 35-year-old woman with a left ovarian tumor underwent left salpingo-oophorectomy, partial resection of the right ovary, and a total hysterectomy. Pathological diagnosis of both ovaries was typical, Krukenberg tumor with signet-ring cells, and the second laparotomy revealed an occult appendiceal tumor to be the primary lesion. The appendix showed no evidence of malignant change of the mucosa, but the tumor cells were observed infiltrating from the basiglandular region into the underlying stroma, associated with mucocele. Although, argentaffin and argyrophil staining were negative, a few tumor cells showed immunohistochemical positivity for Chromogranin A. Accordingly, the tumor was diagnosed as adenocarcinoid rather than adenocarcinoma of the appendix. A review of the literature showed less than 40 cases of metastatic ovarian tumor from appendiceal primary, one-third of which were occult and could be detected at the second laparotomy. Cisplatin-based chemotherapy may have partial effect in the treatment of patient with adenocarcinoid tumor.
Department of Gynecology and Obstetrics, Faculty of Medicine, Kyoto University, Kyoto, Japan.