25 year old patient presented with mass in . iliac fossa, which after laparotomy was found to be carcinoid of 2.5 cm in diameter. What will be the next step in management?
Segmental resection
Rt. hemicolectomy
Appendicectomy
Do yearly 5 HIAA assay
Appendicectomy is the treatment of choice in appendiceal carcinoids < 1 cm in size and tumor size 1-2 cm located at the tip. Rt hemi colectomy is indicated when: Tumor is >2 cm in size Tumor of size 1-2 cm involving base of appendix Tumor of size 1-2 cm involving caecal wall or mesoappendix. Lymph nodes are involved (metastasis present). Also know Treatment for carcinoids of small intestine Carcinoid < 1cm in situ --------- segmental small bowel resection Carcinoid > 1cm in size or multiple tumors or regional lymph node metastasis ------ wide excision of bowel along with its mesentery. Carcinoid of terminal ileum-------- . hemicolectomy Ref: Sabiston 18/e, Page 1345; Schwaz 9/e, page 1088; bailey & Love 24/e, Page 1217.