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

Joanna C. Walsh, David F. Schaeffer, Richard Kirsch, Aaron Pollett, Marco Manzoni, Robert H. Riddell, Luca Albarello

Research output: Contribution to journalArticle

14 Citations (Scopus)

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 languageEnglish
Pages (from-to)123-127
Number of pages5
JournalHuman Pathology
Volume56
DOIs
Publication statusPublished - Oct 1 2016

Fingerprint

Carcinoid Tumor
Neuroendocrine Tumors
Neoplasm Metastasis
Lymph Nodes
Neoplasms
Jejunum
Lymph Node Excision
Ileum
Small Intestine
Gastrointestinal Tract

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 journalArticle

Walsh, Joanna C. ; Schaeffer, David F. ; Kirsch, Richard ; Pollett, Aaron ; Manzoni, Marco ; Riddell, Robert H. ; Albarello, Luca. / Ileal “carcinoid” tumors—small size belies deadly intent : high rate of nodal metastasis in tumors ≤1 cm in size. In: Human Pathology. 2016 ; Vol. 56. pp. 123-127.
@article{ee451da6e84a428693ae9c1653820400,
title = "Ileal “carcinoid” tumors—small size belies deadly intent: high rate of nodal metastasis in tumors ≤1 cm in size",
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.",
keywords = "Carcinoid, Ileum, Lymph node metastasis, Neuroendocrine tumor, Small intestine",
author = "Walsh, {Joanna C.} and Schaeffer, {David F.} and Richard Kirsch and Aaron Pollett and Marco Manzoni and Riddell, {Robert H.} and Luca Albarello",
year = "2016",
month = "10",
day = "1",
doi = "10.1016/j.humpath.2016.05.023",
language = "English",
volume = "56",
pages = "123--127",
journal = "Human Pathology",
issn = "0046-8177",
publisher = "W.B. Saunders Ltd",

}

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 -