title: Surgical management and surveillance of pediatric appendiceal carcinoid tumor.
abstract: OBJECTIVE
  Appendiceal carcinoid tumors are rare neuroendocrine neoplasms. The aim of this study was to determine if postoperative oncologic follow-up was necessary for this tumor.
  
  
  METHODS
  A retrospective review was performed of patients with appendiceal carcinoid 2000-2015.
  
  
  RESULTS
  8382 patients underwent appendectomy 2000-2015. 30 (0.3%) had appendiceal carcinoid. 70% were female (n=21) with an average age of 13.5±2.8 years (range 8-18). Most presented with abdominal pain (n=29, 97%). 20% (n=6) had appendiceal perforation. Mean tumor size was 5.4±4mm (range microscopic - 15mm) with most at the appendiceal tip (n=18, 60%). No node infiltration was found, although 10% (n=3) had perineural and 3% (n=1) had lymphovascular invasion. Five were transmural (17%). Most patients were referred to oncology (n=19, 63%) for staging and surveillance including ultrasonography (n=11, 65%), MRI (n=7, 41%), and CT (n=6, 35%). The majority (79%, n=15) underwent serial 5-HIAA testing. All surveillance was found to be normal, and no patients required further treatment. Mean follow-up was 36±34 months, with 58% (n=11) continuing surveillance. Medical charges ranged $8500-$44,000. No recurrences have been identified.
  
  
  CONCLUSIONS
  Appendectomy is an adequate treatment for pediatric appendiceal carcinoid <16 mm despite presence of histological risk factors. More aggressive surgery and extensive oncologic follow up are of limited value.
  
  
  METHODS
  III.
  
  
  METHODS
  Retrospective comparative study.
authors.affiliation: Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
authors.forename: Inna N
authors.initials: IN
authors.lastname: Lobeck
authors.affiliation: Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
authors.forename: Neelum
authors.initials: N
authors.lastname: Jeste
authors.affiliation: Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
authors.forename: James
authors.initials: J
authors.lastname: Geller
authors.affiliation: Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
authors.forename: Joseph
authors.initials: J
authors.lastname: Pressey
authors.affiliation: Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States. Electronic address: Daniel.vonAllmen@cchmc.org.
authors.forename: Daniel
authors.initials: D
authors.lastname: von Allmen
mesh_terms: D000293:Adolescent; D000359:Aftercare; D001062:Appendectomy; D001063:Appendiceal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002276:Carcinoid Tumor / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007414:Intestinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Appendiceal carcinoid; Carcinoid; Neuroendocrine tumor; Oncologic follow-up