Gastrointestinal Carcinoids: An Increasing Incidence of Rectal Distribution

Abstract

Carcinoid tumors are slow-growing and usually become symptomatic late in the course of the disease. We evaluated our 10-year experience in the management of GI carcinoid tumors. The records of 133 patients with GI carcinoids were reviewed. The rectum was the most common site for carcinoid tumors with an incidence of 30 per cent followed by jejunoileal at 29.3 per cent. Other sites of carcinoid tumors were the appendix (8.3%), colon (8.3%), and duodenum (3.8%). Endoscopy was the most helpful modality in diagnosing GI carcinoids. CT was not helpful in preoperative diagnosis of carcinoid tumor. Fifteen patients died in follow-up with eight deaths related to carcinoid tumors, in the small bowel (6), rectum (1), and colon (1). Overall survival was 68.7 per cent and mortality rate was 19.5 per cent from carcinoid tumors. Most of the deaths occurred in patients with carcinoid syndrome, synchronous malignancy, and malignant carcinoid tumors. The mean disease-free survival was 51 months (range, 15 to 138 months). Screening colonoscopy, in addition to decreasing colorectal adenocarcinoma mortality, is useful in diagnosing carcinoid tumors at an earlier stage and in decreasing mortality from malignant colorectal carcinoid tumors.

Trends of Incidence and Survival of Gastrointestinal Neuroendocrine Tumors in the United States: A Seer Analysis

“…However, we found that overall prevalence of stomach, appendiceal, and colon NETs was higher in women than men, a finding consistent with other reports 9 . Our study demonstrated a significant increase in the incidence of rectal NETs that was more substantial among blacks than whites, an observation in agreement with other studies 10 , 11 . Although we did not investigate the cause of this racial disparity, prior published reports have demonstrated that minorities undergo less frequent screening colonoscopy than whites, but they are more likely to have sigmoidoscopies performed at appropriate intervals 12 .…”

Updating the management of patients with rectal neuroendocrine tumors

“…Regional and metastatic spreading are uncommon at the time of diagnosis, each accounting for 2 % -5 % [1,2,7]. Avenel et al reported that 73 % of 50 rectal carcinoid cases were asymptomatic and were diagnosed during screening colonoscopies [3]. All tumors were < 20 mm in diameter (mean size 8.9 mm) and 96 % were at a localized stage.…”

Radical Operation and Everolimus Therapy for Rectal Neuroendocrine Tumor with Liver Metastases: A Case Report with Review of the Literature

“…NETs are rare tumors, accounting for only 1% -2% of all gastrointestinal tumors [5]. But, RNET account for approximately one third of all digestive neuroendocrine neoplasms (NEN) [6]. However, their effective incidence may be Underestimated.…”