Summary Sentences Patients with appendiceal carcinoid tumors ≤1 cm diagnosed over a 16-year period in a single institution were retrospectively analyzed for disease-specific survival and recurrence. Although there was variation in post-operative surveillance strategies and frequency, there were no cases of tumor recurrence or disease-specific mortality in the follow-up period. Consistent with prior studies, we conclude that post-resection surveillance may not be necessary for tumors ≤1 cm after an R0 resection.

Background The timing of symptom improvement after parathyroidectomy for primary hyperparathyroidism (PHPT) has not been well characterized. Methods This prospective study involved administering a questionnaire to patients with PHPT who underwent curative parathyroidectomy over an 11-month period. The questionnaire evaluated the frequency of 18 symptoms of PHPT on a 5-point Likert scale, and was administered pre-operatively, and 1 week, 6 weeks, and 6 months postoperatively. Results Of 197 eligible patients, 132 (67%) participated in the study. The questionnaires were completed at a rate of 91%, 92%, and 86% at 1 week, 6 weeks, and 6 months post-operatively, respectively. The most commonly reported pre-operative symptoms were fatigue (98%), muscle aches (89%), and bone/joint pain (87%). Improvement in symptom severity occurred across all symptoms and was separated into three categories based on the timing of improvement. Fatigue and bone/joint pain demonstrated ‘Immediate Improvement’ (>50% of patients reporting improvement by post-operative week 1), whereas the majority of symptoms showed peak improvement at 6 weeks (‘Delayed Improvement’). Symptoms categorized as ‘Continuous Improvement’ were those showing progressive improvement up to 6 months post-operatively (polydipsia, headaches, and nausea/vomiting). Conclusions Symptom improvement was most prominent 6 weeks post-parathyroidectomy, though some symptoms showed continued improvement at 6 months.

Background There is a known association between the development of papillary thyroid cancer (PTC) after a primary non-thyroidal cancer (NTC). However, the prevalence of synchronous or antecedent NTCs in patients with PTC is undetermined, as are the clinicopathologic characteristics of PTC in these patients. Study Design A review was performed of our prospectively maintained PTC database between January 1995 and December 2010. Information collected included patient and tumor characteristics, past medical history, PTC presentation, and treatment modality. Results 433 adult patients underwent thyroid resection for PTC. 67 cases of synchronous or antecedent NTCs were observed in 60 patients (13.9%). The most commonly associated antecedent NTCs were breast (n=11), prostate (n=8), and melanoma (n=5), while renal cell carcinoma (n=3) and melanoma (n=3) were the synchronous NTCs most observed. Compared to patients without an NTC, those with an NTC were older (56.4±15.5 vs 44.9±14.2 years, p<0.0001), experienced prior radiation exposure (35.0% vs 3.5%, p<0.001), and more commonly presented with a thyroid mass incidentally on imaging (41.7% vs 9.1%, p=<0.001). PTC tumor characteristics were similar between groups, except that NTC patients presented at a more advanced stage. However, when analyzed independently, primary tumor size, and nodal and distant metastases were comparable. Conclusions The prevalence of synchronous or antecedent NTCs in patients surgically treated for PTC is 13.9%. These patients present with similar PTC tumor characteristics as those without additional NTCs, and should therefore be managed equivalently. In addition, surgeons should be aware of the frequency of synchronous PTC with these types of tumors and consider evaluation of the neck at the time of NTC diagnosis.

Background Extraappendiceal colonic carcinoids are uncommon neuroendocrine tumors with a poor prognosis compared to carcinoids of other gastrointestinal origins. Few studies have examined the clinicopathologic profile and behavior of this rare tumor. Materials and Methods A retrospective analysis was performed on patients with colonic carcinoid tumors evaluated at a single tertiary care center between 1996 and 2012. Collected data included patient and tumor characteristics, presentation, treatment, recurrence and survival. Results were integrated into a comprehensive review of the colonic carcinoid literature. Results In total, 114 patients with colorectal carcinoid tumors were identified, and 15 patients with extraappendiceal tumors were analyzed. The mean age was 58.6±3.0 years, and subjects were predominantly male (73.3%). The most common presenting complaint was abdominal pain (33.3%), although 26.7% of patients were asymptomatic. Cecal tumors were the most prevalent (73.3%), and the majority of patients underwent right hemicolectomy. Three patients with lesions <1 cm were treated endoscopically. The mean tumor diameter was 2.9±0.5 cm, with lymph node or distant metastasis present in 53.3% and 26.7%, respectively. All but 2 patients underwent a presumed curative resection. During a mean follow-up of 4.2±1.0 years, there was only one death (non-carcinoid specific). Eleven patients were alive without evidence of disease at last follow-up, and 3 patients were alive with disease, one of which initially had a presumed curative resection but recurred. Conclusions This case series further elucidates the clinicopathologic characteristics of colonic carcinoid tumors, which aids physicians in guiding the diagnosis and management of these rare tumors.