Editorial
Copyright ©2010 Baishideng.
World J Gastrointest Oncol. Jun 15, 2010; 2(6): 251-258
Published online Jun 15, 2010. doi: 10.4251/wjgo.v2.i6.251
Table 1 Comparison of clinicopathological features of goblet cell carcinoid, carcinoid & adenocarcinoma
Goblet cell carcinoidCarcinoidAdenocarcinoma
Clinical features
Age5th-6th decade4th decade7th decade
Carcinoid syndromeNoYesNo
Primary symptomsAcute appendicitisAcute appendicitisMass
Gross appearance> 2 cm, ill defined thickening< 2 cm> 2 cm, well defined mass
Microscopic appearance
MorphologyClusters of goblet or signet-ring cells separated by fibrosis/pools of mucinNests of small cellsWell-formed glands to sheets of poorly differentiated signet-ring cells
AtypiaMinimalMinimalMarked
MitosisRareRareIncreased
Vascular and perineural invasionPresentAbsentPresent
Infiltrative marginsPresentAbsentPresent
Special stains
ArgyrophilPositivePositiveUsually negative
ArgentaffinNegativePositiveNegative
Mucicarmine/PAS/PASDPositive in goblet cellsNegativePositive
IHC
CEA+-+
CDX2+-+
CAM5.2+-+
CK20±-+
CK7±--
CK19+--
Neuroendocrine markers±±-
Math1 and HD5+-+
p53, p16--+
Molecular pathology
DPC4, Kras, β-catenin mutation and p53 over expression--+
Table 2 Treatment guidelines recommended by various authors (1974-2008)
Subbuswamy et al[2]APX
RH in case of cecal involvement
Klein[3]APX
Haqqani et al[40]RH if base of appendix or caecum is involved
Warkel et al[4]RH in case of spread beyond appendix, atypia, and mitotic count ≥ 2/10 hpf
Chen et al[41]APX alone unless there is cecal involvement
Olsson et al[42]RH in case of spread beyond appendix, atypia, and mitotic count ≥ 2/10 hpf
Edmonds et al[33]RH in all cases
Bak et al[39]RH in case of spread beyond appendix, atypia, and mitotic count ≥ 2/10 hpf
Park et al[43]RH in all cases
Rutledge et al[44]RH in all cases
Butler et al[36]RH for cecal involvement, BSO in females
Ramnani et al[13]< 2 cm in size, without serosal & lymphatic involvement-APX
More advanced tumor-RH
Kanthan et al[30]RH
Li et al[31]RH for N1, M1 or Mib1 > 3%
Varisco et al[23]RH in case of spread beyond appendix, atypia, and mitotic count ≥ 2/10 hpf
Byrn et al[35]No value of RH in non-metastatic cases
Pham et al[22]RH with attendant mesenteric nodal resection for (1) T3/T4 disease or nodal involvement; (2) direct cecal involvement; and (3) clinically positive mesenteric nodes
Bilateral oophorectomy for post menopausal women
O’Donnell et al[20]RH irrespective of stage
Tang et al[17]Group A T1, 2-no recommendations
T3 or 4, group B/C, perforation, positive margin-RH with oophorectomy if possible. CT in stage III/IV
Stage IV/group C- debulking/oophorectomy/systemic/intraperitoneal CT