Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 123-127 |
| Number of pages | 5 |
| Journal | Human Pathology |
| Volume | 56 |
| DOIs | |
| Publication status | Published - Oct 1 2016 |
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Keywords
- Carcinoid
- Ileum
- Lymph node metastasis
- Neuroendocrine tumor
- Small intestine
ASJC Scopus subject areas
- Pathology and Forensic Medicine
Cite this
Ileal “carcinoid” tumors—small size belies deadly intent : high rate of nodal metastasis in tumors ≤1 cm in size. / Walsh, Joanna C.; Schaeffer, David F.; Kirsch, Richard; Pollett, Aaron; Manzoni, Marco; Riddell, Robert H.; Albarello, Luca.
In: Human Pathology, Vol. 56, 01.10.2016, p. 123-127.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Ileal “carcinoid” tumors—small size belies deadly intent
T2 - high rate of nodal metastasis in tumors ≤1 cm in size
AU - Walsh, Joanna C.
AU - Schaeffer, David F.
AU - Kirsch, Richard
AU - Pollett, Aaron
AU - Manzoni, Marco
AU - Riddell, Robert H.
AU - Albarello, Luca
PY - 2016/10/1
Y1 - 2016/10/1
N2 - 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.
AB - 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.
KW - Carcinoid
KW - Ileum
KW - Lymph node metastasis
KW - Neuroendocrine tumor
KW - Small intestine
UR - http://www.scopus.com/inward/record.url?scp=84979912956&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84979912956&partnerID=8YFLogxK
U2 - 10.1016/j.humpath.2016.05.023
DO - 10.1016/j.humpath.2016.05.023
M3 - Article
AN - SCOPUS:84979912956
VL - 56
SP - 123
EP - 127
JO - Human Pathology
JF - Human Pathology
SN - 0046-8177
ER -