FINAL DIAGNOSIS GOBLET CELL CARCINOID
GOBLET CELL CARCINOID
Also called mucinous carcinoid, adenocarcinoid, microglandular goblet cell carcinoma.
Shows divergent differentiation of normal crypt stem cells (columnar, endocrine, goblet cell, Paneth cell lineages).
Occurs in an older age group then conventional carcinoid.
Often associated with perforative appendicitis.
The behaviour of the Goblet Cell Carcinoid is more aggressive than that of the classic carcinoid particularly if the tumor has transmural involvement, extends into the cecum, is larger than 2 cm and shows the presence of signet ring cells.
Bad PROGNOSTIC FACTORS
Metastasis has been documented particularly to the ovary.
CYTOGENETICS
loss of heterozygosity of 18q (56%), 16q (38%), 11q (25%), resemble ileal carcinoids more than appendiceal adenocarcinoma
TREATMENT
Right hemicolectomy is recommended for this tumor type especially with
-spread beyond the appendix
-size of the tumor more than 2cm
DIFFERENTIAL DIAGNOSIS
Contributed by Sonal Kamat, MD