Læknablaðið - 15.10.1989, Blaðsíða 23

LÆKNABLAÐIÐ
291
15,9 ár frá aðgerð og hjá sex sjúklingum >20
ár. Við teljum því að það eina 0,9 cm æxli
sem hafði myndað meinvörp réttlæti ekki
ristilbrottnám hjá þeim 19% sjúklinga sem
höfðu æxli á bilinu 0,9-1,4 cm því enginn
annar sjúklingur í þem hópi fékk merki um
endurvöxt krabbalíkis.
Þakkir: Grein þessi er hluti verkefnis
sem styrkt var af Vísindasjóð íslands og
Minningarsjóð Bergþóru Magnúsdóttur og
Jakobs J. Bjamasonar. Yfirlæknar deilda og
sjúkrahúsa veittu góðfúslega aðgang að sjúkra-
og rannsóknarskýrslum.
SUMMARY
Seventy-eight histologically verified cases of
appendiceal carcinoid tumors were diagnosed in
Iceland in the 30-year period 1955-1984. These
have been retrospectively analysed as demonstrated
in Tables I-VI. Appendiceal carcinoids were 53%
of all carcinoid tumors diagnosed in that period
and 66% of gastrointestinal carcinoids. The annual
crude incidence of appendiceal carcinoids was 1,2
per 100.000 inhabitants (females 1,9 and males
0,62). The age ranged from 4 to 72 years, average
29 years. Children under the age of 16 years were
18. The tumor was not diagnosed preoperatively in
any patient. The indication for appendectomy was
acute appendicitis in 51% of the patients. Average
tumor size as measured in histological sections was
0,60 cm - 79% were located in the distal third of
the appendix and in 28% of the cases the tumor
had invaded the mesoappendix. One patient with
a 0,9 cm primary tumor had metastases. In 74
patients a standard appendectomy was the only
surgical procedure performed. On Dec lst 1986
six of the 78 patients had died, but none of the
carcinoid tumor. All other patients were alive
without evident recurrent disease with an average
follow-up time of 15 years.
We conclude that standard appendectomy
is adequate treatment for the vast majority
of carcinoid tumors of the appendix and
that complementary treatment or follow-up
investigations are rarely indicated.
HEIMILDIR
1. Ahlman H. Midgut carcinoid tumors. Surg Ann 1986;
18: 65-93.
2. Godwin JD. Carcinoid tumors. An analysis of 2837
cases. Cancer 1975; 36: 560-9.
3. Anderson JR, Wilson BG. Carcinoid tumours of the
appendix. Br J Surg 1985; 72; 545-6.
4. Mártensson H. Gut endocrine tumors (Thesis).
University of Lund 1983.
5. Moertel CG, Dockerty MB, Judd ES. Carcinoid
tumors of the vermiform appendix. Cancer 1968; 21:
270-8.
6. Moertem CG, Weiland LH, Nagomey DM, Dockerty
MB. Carcinoid tumor of the appendix: Treatment and
prognosis. N Eng J Med 1987; 317: 1699-1701.
7. Andersson Á, Bergdahl L. Carcinoid tumors of the
appendix in children. Acta Chir Scand 1977; 143:
173-5.
8. Dymock RB. Pathological changes in the appendix:
review of 1000 cases. Pathology 1977; 9: 331-9.
9. Berge T, Linell F. Carcinoid tumors. Frequency in a
defined population during a 12-year period. Acta Path
Microbiol Scand Sect A 1976; 84: 322-30.
10. Syracuse DC, Perzin KH, Price JB, Wiedel PD,
Mesa-Tejada R. Carcinoid tumors of the appendix.
Ann Surg 1979; 190: 58-63.
11. Þorkelsson Þ, Jóhannsson JH. Botnlangabólga og
aðrir sjúkdómar í botnlanga. Læknaneminn 1984;
37: 45-52.
12. Aho AJ, Heinonen RJ, Laurén PA. Carcinoid tumours
of the appendix. Acta Chir Scand 1971; 137: 801-6.
13. Bowman GA, Rosenthal D. Carcinoid tumors of the
appendix. Am J Surg 1983; 146: 700-3.
14. Glasser CM, Bhagavan BS. Carcinoid tumors of the
appendix. Arch Pathol Lab Med 1980; 104: 272-5.
15. Lau W, Fan S, Yiu T et al. The clinical significance
of routine histopathologic study of the resected
appendix and safety of appendiceal inversion. Surg
Gynecol Obstet 1986; 162: 156-8.
16. Ponka JL. Carcinoid tumors of the appendix. Am J
Surg 1973; 126: 77-83.
17. Svendsen LB, Búlow S. Carcinoid tumours of the
appendix in young patients. Acta Chir Scand 1971;
146: 137-9.
18. Ryden SE, Drake RM, Franciosi RA. Carcinoid
tumors of the appendix in children. Cancer 1975;
36: 1538-42.