CARCINOID TUMOR OF THE VERMIFORM APPENDIX WITH DISTANT METASTASIS.

Metastatic carcinoid tumors of the appendix are probably not as rare as is commonly thought. In five of thirteen cases diagnosed at the Stanford-Palo Alto Hospital, there was microscopic evidence of lymphatic invasion. Metastasis to regional nodes was demonstrated in two of the five. These two cases bring the total number reported in the medical literature to 31. One of the patients was a 14-year-old girl. The youngest patient previously cited with metastasis from carcinoid tumor of the appendix was 16 years of age. We believe that all carcinoid tumors, regardless of location, are malignant lesions and urge careful pathologic study for evidence of lymphatic invasion. When such invasion is present, removal of regional nodes by right hemicolectomy seems indicated.