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home - Colon - Colorectal and Anal Cancer - Colonic Carcinoid Written by Dr Sebastian Zeki
Knowledge

Knows the pathology of benign and malignant tumours of the colon
and rectum
Has awareness of the molecular genetics of colorectal
carcinogenesis and the adenoma-carcinoma sequence
Knows the range of predisposing conditions including inherited
syndromes and acquired colonic diseases
Knows the range of clinical presentation and the means of
diagnosis, investigation, management and follow-up
Knows the strategy for prevention including procedures for
screening

Skills
Uses clinical assessment and selects investigations to reach a rapid
conclusion as to whether a patient might have colorectal cancer and
arranges timely investigation.
Refers the patient to the multi-disciplinary team CbD, mini-CEX,

Behaviours
Shows ability to react to possible diagnosis of malignancy in a timely
manner

Communicates with patient and family in a sympathetic and
understanding manner, explains next steps, involves other health
professionals (including the GP) as appropriate

Colonic Carcinoid

Appendeal CarcinoidsCarcinoid tumors are the most common neoplasms in the appendix.Carcinoids present in 1 in 300 appendixes-usually incidental.The average age of presentation is in the 40’s.They are mosr commo in females.Presentation is usually symptomatic unless large / mets/ at base of appendix (cause appendicitis).Treatment involves simple appendectomy if <2cm or right hemicolectomy if larger as it can recur. Colon CarcinoidIt is usually asymptomatic and detected late (5cm average size at diagnosis).Patients are diagnosed in their 70’s.Usually right sided/ caecum.Staging is by TNM.5yr survival rates were 97 to 17 % for stages I to IV.Small localized tumors are most likely to be cured by resection. Rectal CarcinoidsAverage age of presentation is in the 60’s.> 70 % of those over 2 cm metastasize to LN/liver.5 year survival for stage 4 is 26%. <2cm >2cm Low anterior resection/ AP resection Transanal resection/ endoscopic resection Treatment Colonic Carcinoid Arise from endocrine cells in the lamina propria and submucosa. Usually in the distal 1/3rd of the appendix- 10% in the base Distant metastatic spread 32 %30% of >2cm will have metastasized Written by Dr Sebastian Zeki

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