Ileal “carcinoid” tumors—small size belies deadly intent: high rate of nodal metastasis in tumors ≤1 cm in size

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• 作者：Joanna C. Walsh ; MBBCh ; MRCP(UK) ; FRCPC^a ; ^{joanna.walsh@lhsc.on.ca" class="auth_mail" title="E-mail the corresponding author} ; David F. Schaeffer ; MD ; PhD ; FRCPC^b ; Richard Kirsch ; MBChB ; PhD ; FRCPath(SA) ; FRCPC^c ; Aaron Pollett ; MD ; MSc ; FRCPC^c ; Marco Manzoni ; MD^d ; Robert H. Riddell ; MD ; FRCPath(UK) ; FRCPC^c ; Luca Albarello ; MD^e
• 关键词：Neuroendocrine tumor ; Carcinoid ; Ileum ; Small intestine ; Lymph node metastasis
• 刊名：Human Pathology
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：56
• 期：Complete
• 页码：123-127
• 全文大小：1332 K

文摘

Neuroendocrine tumors (NETs) account for 2% of tumors of the gastrointestinal tract, most occurring in the small intestine. A size of 2 cm is generally regarded as a cut-off point for risk of lymph node metastasis in intestinal neuroendocrine tumors in the absence of other high-risk features; however, metastatic disease has been reported in 12% of tumors of the jejunum and ileum measuring 1 cm or less. Archives from 2 institutions were searched for ileal NETs measuring 1 cm or less, and selected data were recorded. Twenty-one ileal NETs were identified measuring ≤ 1 cm. Six (29%) were multifocal and 7 (33%) had distant metastasis at diagnosis. Regional lymph nodes were examined in 14 cases (67%), and 10 of these cases (71%) showed lymph node metastasis. Mean primary tumor size in cases with nodal metastasis was 7.3 mm. In this series of ileal NETs ≤ 1 cm in size, the rate of lymph node metastasis was 48% overall and 71% for cases with regional lymph node resections. In addition, 33% showed distant metastasis at the time of diagnosis. Tumors as small as 3 mm and those confined to the submucosa can give rise to nodal metastasis, emphasizing the need for consideration of local resection with regional lymphadenectomy, even for subcentimeter ileal NETs.