Appendiceal Carcinoid Tumor in Children: a Conservative Surgical Approach

Carcinoid tumors of the appendix are slow-growing tumors and, although rare, they are the most common gastrointestinal epithelial tumors in childhood and adolescence. The treatment and the follow-up have been guided by adult presentations and outcomes, although have not been clearly standardized in children. A retrospective review was performed in all cases of appendiceal carcinoids in children over a 20-year period. Data regarding clinical presentation, diagnosis, surgical treatment, pathology, follow-up, and outcomes were collected and analyzed. We identified eight cases of appendiceal carcinoids. All cases were diagnosed after appendectomy for presumed appendicitis, with no patient having carcinoid syndrome. The patients include five females and three males with an average age of 15 years at presentation. Tumor size ranged from 4 to 20 mm (mean 13 mm). Four cases had invasion of mesoappendix, two of which underwent a subsequent right hemicolectomy. No patient had evidence of lymphatic invasion after right colectomy. Mean follow-up was 112 months and no patients had recurrence and liver metastases. We found no evidence of carcinoid syndrome or metastatic disease in our patients. Follow-up utility is questionable in these cases. The need for a secondary colectomy is questionable in this age group and restricted to rare conditions.