Carcinoid tumors of the appendix. A report of 4 cases

Four cases of carcinoid tumors of the vermiform appendix are reported. Clinical presentation in 3 cases was suggestive of acute appendicitis and they were submitted to appendicectomy. The carcinoid tumor was discovered by the pathologist on specimen of appendix. The tumors's size, less than 2 cm, the absence of serosal involvement and lymphatics invasion suggested that simple appendicectomy was a satisfactory treatment for such patients. Occasionally clinical presentation of appendiceal carcinoid is characterized by symptoms of intestinal obstruction or intussusception, palpable mass, bleeding. In the fourth patient, that had symptoms consistent with heal occlusion, we found at laparotomy a bulky tumor of the base of appendix infiltrating and obstructing the cecum and right colon, without liver metastases. A right hemicolectomy with end-to-end anastomosis was performed. Aggressive behaviour of this tumor was also revealed by the single pulmonary metastasis, finding very uncommon in carcinoid of appendix. This patient died postoperatively, at 25th day, of septic abdominal complications, secondary to anastomotic leak. The former patients at clinical and radiological (CT scan) follow-up performed at 3, 12, 36 months respectively, are still alive and disease free.