Carcinoid tumours of the appendix in children in Auckland, New Zealand: 1965-2008.

AIMS: Carcinoid tumours (CT) of the appendix are rare in children. The study aims to review paediatric CT of the appendix in Auckland and conduct a literature review. METHOD: Retrospective review of all CT of the appendix at the Auckland paediatric hospital from 1965 until 2008. Patients were identified from the Auckland Laboratory Pathology Department database. Patient charts and histopathological slides were reviewed when available. RESULTS: 47 children had a histologically confirmed CT of the appendix (34 females, 12 males). Mean age 12.3 years (7-15 years). Mean tumour diameter 0.83 cm (range 0.1 cm-2.3 cm). 55% tumour diameter <1 cm. Two patients had tumour diameters >2 cm. Extent of invasion known in 38 patients. Four within appendiceal submucosa, 11 into muscularis, 15 into serosa and 8 cases tumour extended to mesoappendix. Suspected appendicitis was the indication for surgery in each case. 44 patients had appendicectomy only, 3 patients had right hemicolectomy with residual tumour in one specimen. Literature search revealed 88 studies of which 11 case series of CT of the appendix in children were compared to our own study. CONCLUSION: CT of the appendix in children are uncommon. Most will be cured by appendicectomy only. Recurrence and metastatic disease are rare. Mesoappendiceal invasion is not an absolute indication for further surgery.