Extra-appendicular carcinoid tumors of the gastrointestinal tract.
During the years 1958-1978, seventeen patients were treated for extra-appendicular carcinoid tumors of the gastrointestinal tract in Tel-Hashomer and Belinson hospitals. Most of the tumors were located in the colon (eight cases) and in the rectum (four cases). A direct correlation between the tumor size and invasiveness has been noted, with distant metastases in eight of 12 patients with tumors more than 2 cm in size. Gastrointestinal bleeding was the most frequent clinical symptom, whereas the "carcinoid syndrome" appeared only in three patients. Curative surgery was performed in six patients, palliative procedure in two cases, explorative laparotomy was performed in four cases, and in two patients diagnosis was made in postmortem examination. Eight of the 17 patients (47%) had distant metastases at the time of the diagnosis, and six of the 15 operated patients (40%) died during the first year after the operation. The malignant nature of these tumors, together with the high incidence (23%) of associated malignant neoplasms is stressed. Radical resection is advocated in the cases where the tumor's size is more than 2 cm or in the presence of muscular invasion.