From the Guidelines
Adenocarcinoid tumor, also known as goblet cell carcinoid, is a rare type of cancer that has features of both adenocarcinoma and carcinoid tumors, and its management should prioritize surgical resection, with the extent of surgery depending on the tumor size, location, and whether it has spread, as supported by 1.
Key Characteristics
- Adenocarcinoid tumors most commonly occur in the appendix but can also develop in other parts of the gastrointestinal tract.
- They are characterized by a mixed cellular composition, containing both neuroendocrine cells and mucin-producing goblet cells.
- These tumors typically behave more aggressively than traditional carcinoid tumors but less aggressively than pure adenocarcinomas.
Treatment Approach
- Surgical resection is the primary treatment, with the goal of removing the tumor while preserving as much tissue as possible, as recommended by 1.
- For appendiceal adenocarcinoids, an appendectomy may be sufficient for small, localized tumors, while right hemicolectomy might be recommended for larger or more invasive tumors.
- In cases with metastatic spread, additional treatments such as chemotherapy may be necessary, with somatostatin analogs considered for first-line systemic antiproliferative treatment in unresectable cases, as suggested by 1.
Prognosis and Follow-Up
- The prognosis varies based on the stage at diagnosis, with earlier stages having better outcomes, as indicated by 1.
- Regular follow-up is essential after treatment to monitor for recurrence, as these tumors can return even years after initial treatment.
Important Considerations
- The treatment approach should be individualized based on the tumor's characteristics, size, location, and whether it has spread.
- A multidisciplinary team should be involved in the management of adenocarcinoid tumors to ensure the best possible outcomes, considering the latest recommendations from 1.
From the Research
Definition and Characteristics of Adenocarcinoid Tumors
- Adenocarcinoid tumors are not explicitly defined in the provided studies, but they can be related to carcinoid tumors, which are a type of neuroendocrine tumor.
- Carcinoid tumors are rare and slow-growing, with a propensity to affect all organs, but most commonly involve the gastrointestinal tract and lungs 2.
- These tumors secrete a variety of peptides and neuroamines, leading to varied clinical presentations depending on the involved organ and produced neuroactive amines.
Diagnosis and Treatment of Carcinoid Tumors
- The diagnosis of carcinoid tumors often involves the estimation of 5-HIAA in 24-hour urine, which is highly specific, and serum chromogranin, which is highly sensitive even in non-secretory carcinoids 2.
- Imaging modalities such as Octreoscan and MIBG are useful in diagnosing and monitoring carcinoid tumors, and may be more effective than computed tomography or magnetic resonance imaging alone 2, 3, 4.
- Treatment of carcinoid tumors involves a multidisciplinary approach, including resection of primary tumor and debulking, embolisation of liver carcinoids, somatostatin analogues, and chemotherapy 2, 3, 5.
Neuroendocrine Tumors
- Neuroendocrine tumors, which include carcinoid tumors, are a heterogeneous group of neoplasms that can originate in various organs, including the lungs, GI tract, and pancreas 6.
- The selection of initial and subsequent therapies for neuroendocrine tumors requires careful consideration of both tumor and treatment characteristics 6.
- Recent advances in the field of neuroendocrine tumors have provided more tools for diagnosis and treatment, including somatostatin receptor-based imaging and molecular target therapy with Sunitinib and Bevacizumab 2, 6.