An extremely rare finding of goblet cell carcinoid of the appendix. A case report

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Lavinia Amato
Manuel Valeri
Adolfo Petrina
Michela Boncompagni
Nadia Pietropaoli
Roberto Ciaccarini

Abstract

 

Goblet cell carcinoid or carcinoma (GCC) refers to an extremely rare appendiceal tumor usually diagnosed on post-operative histology as an incidental finding. Primary cancers of the vermiform appendix are quite rare, representing less than 1% of all gastrointestinal malignancies. GCCs are considered as a distinct entity of appendiceal tumors, consisting of both epithelial (glandular) and neuroendocrine elements containing goblet cells. This entity tends to be more aggressive than typical carcinoid tumors as it often presents with metastatic disease. Therefore, an early recognition and an appropriate grading is essential. The 5-year overall survival is 14-22% in stage III-IV disease. As a matter of fact, GCC warrants more aggressive surgical and medical (chemotherapy) treatments than typical carcinoid tumors. We, hereby, report a case of a 67-year old male presenting with an acute abdominal obstruction and a severe tenderness predominant in his right lower quadrant, together with an endoscopic and radiological suspect of left colonic malignancy and acute appendicitis. Left hemicolectomy and appendicectomy were performed and pathological specimens revealed a lowgrade adenocarcinoma of the descending colon and a high-grade appendiceal goblet cell carcinoid. Subsequent right hemicolectomy was performed according to the current guidelines. GCCs are more aggressive compared with conventional appendiceal tumors but less aggressive compared with adenocarcinomas and they often present with serosal and mesoappendiceal involvement. The lack of a standardized classification system for GCC and the discrepancies in specific reliable markers are responsible for an insufficient prognostic and predictive value at diagnosis.


 

 

 

 


 

Article Details

How to Cite
Amato, Lavinia, et al. “An Extremely Rare Finding of Goblet Cell Carcinoid of the Appendix. A Case Report”. Annali Italiani Di Chirurgia, vol. 10, no. September, Sept. 2021, pp. 1-6, https://annaliitalianidichirurgia.it/index.php/aic/article/view/691.
Section
Case Report
Author Biographies

Lavinia Amato, Department of General Surgery, University of Perugia, Medical School, Perugia, Italy

 

 

     

Manuel Valeri, Department of General Surgery, University of Perugia, Medical School, Perugia, Italy

 

 

     

Adolfo Petrina, General Surgery, Santa Maria della Misericordia Hospital, Perugia, Italy

 

 

     

Michela Boncompagni, General Surgery, Santa Maria della Misericordia Hospital, Perugia, Italy

 

 

     

Nadia Pietropaoli, Pathological Anatomy and Histology, Santa Maria della Misericordia Hospital, Perugia, Italy

 

 

     

Roberto Ciaccarini, General Surgery, Santa Maria della Misericordia Hospital, Perugia, Italy