Surgery>>>>>The Appendix
Question 7#

While reviewing pathology of a recent laparoscopic appendectomy, you note that in addition to acute appendicitis, the patient had a 1.5-cm carcinoid tumor located at the base of the appendix. The patient is otherwise healthy and recovering well from surgery. What would you recommend?

a. No additional therapy necessary
b. Right hemicolectomy
c. Radical appendectomy
d. Adjuvant chemotherapy

Correct Answer is B

Comment:

Appendiceal carcinoid is one of the most common neoplasms to identify in an appendectomy specimen. Lesions that are < 1 cm generally do not require additional therapy. Lesions larger than 1 or 2 cm, involving the appendiceal base or with lymph node metastasis of mesenteric invasion warrant right hemicolectomy. A radical appendectomy is not a described operation and adjuvant chemotherapy could be considered but only after definitive surgical care.