Appendiceal carcinoid tumor with lymph node metastasis in a child: case report and review of the literature

Appendiceal carcinoids in children—management and outcomes

“…All cases were limited to regional lymph nodes, and there were no reports of distant (liver) metastases from this tumor. In our series, we report the fourth case of regional lymph node metastasis from an appendiceal carcinoid in a child [5,11,12]. In general, tumor size >2 cm predicts lymph node metastasis, and at 2.1 cm, our case is consistent with this observation.…”

“…Tumors have been divided into risk groups based on diameter, with those <1 cm having the lowest metastatic potential and lesions >2 cm, the highest. The vast majority of children (72%e95%) present with a tumor <1 cm [5,8]. Current guidelines for adult patients state that secondary right hemicolectomy is indicated for tumors >2 cm, incompletely resected tumor, lymphovascular invasion, invasion of the mesoappendix, or high grade or mixed histology [6,9].…”

“…In general, tumor size >2 cm predicts lymph node metastasis, and at 2.1 cm, our case is consistent with this observation. Only one case of regional lymph node metastasis has been reported in a tumor <2 cm [5].…”

“…The outcomes of roughly 200 documented cases have guided the recommendations at this point [2]. Extended resections and colectomies are currently recommended for tumors >2 cm in adults, but the need for that in the pediatric age group is unclear as there are anecdotal reports of children with tumors >2 cm who have remained disease free for 10 y after appendectomy alone [4,5]. Thus, some authors are beginning to advocate for less-aggressive management of appendiceal carcinoid tumors in children [4].…”

Appendiceal neuroendocrine neoplasms: diagnosis and management

“…Historically, the presence of regional LN metastases from an aNEN has mainly been reported in isolated case reports, including 14-year-old children (Supplementary Table 4, see section on supplementary data given at the end of this article) (Kieraldo et al 1963, Skaane & Eide 1977, Deeg et al 2003, Cernaianu et al 2010. When the primary tumour involves the appendix wall diffusely, lymphatic permeation to the regional LN was reported in 50% of 21 cases (Dunn 1982).…”