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Pediatric Surgery International

, Volume 35, Issue 12, pp 1427–1430 | Cite as

Management of pediatric appendiceal carcinoid: a single institution experience from 5000 appendectomies

  • Chirath Ranaweera
  • Amanpreet Brar
  • Gino R. Somers
  • Furqan Sheikh
  • Agostino Pierro
  • Augusto ZaniEmail author
Original Article

Abstract

Aim of the study

Appendiceal carcinoid (neuroendocrine tumor or NET) is a rare neuroendocrine neoplasm often found incidentally following appendectomy for appendicitis. Surgery for appendicitis is currently under scrutiny and children are increasingly managed conservatively with antibiotics alone. Herein, we aimed to review our experience with the management of appendiceal carcinoids at our institution.

Methods

Following ethical approval, we reviewed the charts of all patients who underwent appendectomy for appendicitis at our institution between 2000 and 2018. The pathology registry was consulted to identify children diagnosed with appendiceal carcinoid. Outcome measures included incidence, demographics, and management.

Main results

During the study period, 32 children (23 female) had an appendiceal carcinoid confirmed at pathology. Of these, 13 were initially treated with appendectomy (total of 5,059 appendectomies: 0.3% incidence). The other 19 had an appendectomy elsewhere by an adult general surgeon and were referred to our institution for further management. Overall, the mean age at diagnosis was 13 ± 2.7 years and all patient had a preoperative diagnosis of appendicitis, none of suspected carcinoid. Most children (75%) had acute non-perforated appendicitis. The overall mean size of the lesion was 1 ± 0.9 cm, with a > 2 cm lesion in 3 patients. Following diagnosis, 12 children (38%) underwent an ileocolic resection, due to carcinoid size, invasiveness, and margin clearance.

Conclusions

In our cohort, the incidence of appendiceal carcinoid among children with appendicitis is very low. Most carcinoids are small, located at the tip, associated with non-perforated appendicitis, and present in girls. Most were treated with appendectomy alone, with more extensive surgery performed in one third of children.

Keywords

Appendicitis Appendicular carcinoid Non-operative Antibiotic Appendicectomy 

Notes

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Chirath Ranaweera
    • 1
  • Amanpreet Brar
    • 1
  • Gino R. Somers
    • 2
  • Furqan Sheikh
    • 3
  • Agostino Pierro
    • 1
  • Augusto Zani
    • 1
    Email author
  1. 1.Division of General and Thoracic SurgeryHospital for Sick ChildrenTorontoCanada
  2. 2.Division of Pathology, Department of Pediatric Laboratory MedicineHospital for Sick ChildrenTorontoCanada
  3. 3.Division of Hematology/OncologyHospital for Sick ChildrenTorontoCanada

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