During appendicectomy for presumed appendicitis, histology reveals a 1.5 cm well-differentiated neuroendocrine (carcinoid) tumor located entirely at the tip of the appendix, with clear resection margins. No nodal disease is reported. What is the correct further management?
- A Right hemicolectomy in all cases of appendiceal carcinoid
- B Completion appendicectomy with omentectomy
- C No further surgery; surveillance is sufficient ✓
- D Octreotide therapy for six months
Correct answer: C. No further surgery; surveillance is sufficient
Explanation
Appendiceal carcinoids smaller than 2 cm confined to the tip with clear margins have negligible risk of nodal metastasis and are adequately treated by simple appendicectomy alone. Right hemicolectomy is indicated for tumors larger than 2 cm, invasion of the mesoappendix, positive margins, involvement of the appendiceal base, or goblet cell carcinoids. Octreotide is reserved for functioning metastatic disease.
Reference: Sabiston Textbook of Surgery, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.