Carcinoid tumors of the appendix may be either benign or malignant. The presence of certain pathologic findings correlate with a more aggressive course and the need for more extensive surgery.
The presence of one or more of the following findings is an indication for hemicolectomy:
(1) tumor arising at the appendiceal base
(2) tumor present in the resection margin
(3) tumor invasion of the mesoappendix
(4) lymphatic and/or perineural invasion
(5) tumor diameter >= 2 cm
(6) evidence of metastases
(7) high mitotic rate
(8) mucinous histology
where:
• The tumor diameter should be based on the fresh specimen, since fixation of the lesion may result in shrinkage of the tumor by up to 30%.
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