Skip to main content
Log in

Composite (Adenocarcinoid) tumors of the gastrointestinal tract

  • Case Report
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Summary

Tumors of the gut with composite features of both adenocarcinoma and carcinoid have been recognized mainly in the appendix. There also have been isolated reports of similar tumors arising from other parts of the gastrointestinal tract. It is generally concluded that these tumors have better prognosis than adenocarcinomas of the gastrointestinal tract. We reported six patients with composite tumors arising from the stomach in one, small intestine in two, cecum in two, and rectum in one patient. Clinical presentations in each was suggestive of malignancy with extension to either serosa and/or lymph nodes. Metastasis to liver was present in two patients. Histologically, the tumor showed glands with surface microvilli resembling adenocarcinoma and also organoid pattern with neurosecretory granules in cells resembling carcinoid. Two patients died three and nine months after surgery. The clinical presentation, findings at operation, and the postsurgical course of these six patients reveal that these tumors behave more like an adenocarcinoma than carcinoid and do not appear to have a better prognosis than ordinary adenocarcinoma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hernandez F, Fernandez BB: Mucin-secreting colonic carcinoid tumors. Dis Colon Rectum 17:387–396, 1974

    PubMed  Google Scholar 

  2. Rosai J, Levine G, Weber RW, et al: Carcinoid tumors, and oat cell carcinomas of the thymus. Pathol Annu 11:201–226, 1976

    PubMed  Google Scholar 

  3. Smith DM, Haggitt RC: The prevalence and prognostic significance of argyrophil cells in colorectal carcinomas. Am J Surg Pathol 8:123–128, 1984

    PubMed  Google Scholar 

  4. Lewin K: Carcinoid tumors and the mixed (composite) glandular-endocrine cell carcinomas. Am J Surg Pathol 11(suppl l):71–76, 1987

    PubMed  Google Scholar 

  5. Klappenbach RC, Kurman RJ, Sinclair CF, James LP: Composite carcinoma-Carcinoid tumors of the gastrointestinal tract. A morphologic, histochemical, and immunocytochemical study. Am J Clin Pathol 84:137–143, 1985

    PubMed  Google Scholar 

  6. Olsson B, Ljungberg O: Adenocarcinoid of the vermiform appendix. Virchows Arch A Pathol Anat Histol 386:1–10, 1980

    PubMed  Google Scholar 

  7. Zirkin RM, Brown S, Hertz M: Adenocarcinoid of appendix presenting as bilateral ovarian tumors. Diag Gynecol Obstet 2:269–274, 1980

    Google Scholar 

  8. Warkel RL, Cooper PH, Helwig EB: Adenocarcinoid a mucin producing carcinoid tumor of the appendix. A study of 39 cases. Cancer 42:2781–2793, 1978

    PubMed  Google Scholar 

  9. Miller RT, Sarikaya H, Jenison EL: Adenocarcinoid tumor of appendix presenting as unilateral Krukenberg tumor. J Surg Oncol 37:65–71, 1988

    PubMed  Google Scholar 

  10. Bak M, Jorgensen LJ: Adenocarcinoid of the appendix presenting with metastasis to the liver. Dis Colon Rectum 30:112–115, 1987

    PubMed  Google Scholar 

  11. Isaacson P: Crypt cell carcinoma of the appendix (so-called adenocarcinoid tumor). Am J Surg Pathol 5:213–224, 1981

    PubMed  Google Scholar 

  12. Rodriquez FH, Sarma DP, Lunseth JH: Goblet cell carcinoid of the appendix. Hum Pathol 13:286–288, 1982

    PubMed  Google Scholar 

  13. Cooper PH, Warkel RL: Ultrastructure of the goblet cell type of adenocarcinoid of the appendix. Cancer 42:2687–2695, 1978

    PubMed  Google Scholar 

  14. Edmonds P, Merino MJ, LiVolsi VA, Duray PH: Adenocarcinoid (mucinous carcinoid) of the appendix. Gastroenterology 86:302–309, 1984

    PubMed  Google Scholar 

  15. Gibbs NM: The histogenesis of carcinoid tumors of the rectum. J Clin Pathol 16:206–214, 1963

    PubMed  Google Scholar 

  16. Hernandez F, Reid JD: Mixed carcinoid and mucussecreting intestinal tumors. Arch Pathol 88:489–496, 1969

    PubMed  Google Scholar 

  17. Lyss AP, Thompson JJ, Glick JH: Adenocarcinoid tumor of the colon arising in preexisting ulcerative colitis. Cancer 48:833–839, 1981

    PubMed  Google Scholar 

  18. Bates HR, Belter LF: Composite carcinoid tumor (argentaffinoma-adenocarcinoma of the colon). Report of two cases. Dis Colon Rectum 10:467–470, 1967

    PubMed  Google Scholar 

  19. Toker C: Observations on the composition of certain colonic tumors. Cancer 24:256–260, 1969

    PubMed  Google Scholar 

  20. Rogers LW, Murphy RC: Gastric carcinoid and gastric carcinoma. Am J Surg Pathol 3:195–202, 1979

    PubMed  Google Scholar 

  21. Murayama H, Imai T, Kikuchi M: Solid carcinomas of the stomach: A combined histochemical light and electron microscopic study. Cancer 51:1673–1681, 1983

    PubMed  Google Scholar 

  22. Ali MH, Davidson A, Azzopardi JG: Composite gastric carcinoid and adenocarcinoma. Histopathology 8:529–536, 1984

    PubMed  Google Scholar 

  23. Yamashina M, Flinner RA: Concurrent occurrence of adenocarcinoma and carcinoid tumor in the stomach: A composite tumor or collision tumors. Am J Clin Pathol 83:233–236, 1985

    PubMed  Google Scholar 

  24. Parks TG: Malignant carcinoid and adenocarcinoma of the stomach Br J Surg 57:377–379, 1970

    PubMed  Google Scholar 

  25. Soga J, Tazawa K, Aizawa O, Wada K, Tuto T: Argentaffin cell adenocarcinoma of the stomach: An atypical carcinoid? Cancer 28:999–1003, 1971

    PubMed  Google Scholar 

  26. Wheeler DA, Chandrasoma P, Carriere CA, Schwinn CP: Cytologic diagnosis of gastric composite adenocarcinomacarcinoid. Acta Cytol 28:706–708, 1983

    Google Scholar 

  27. Goldberg SL, Toker C: Composite tumor of small intestine. Mount Sinai J Med 43:153–156, 1976

    Google Scholar 

  28. Wisniewski M, Toker C: Composite Tumor of the gallbladder exhibiting both carcinomatous and carcinoidal patterns. Am J Gastroenterol 58:633–637, 1972

    PubMed  Google Scholar 

  29. Godwin JD, II: Carcinoid tumors. An analysis of 2837 Cases. Cancer 37:560–569, 1975

    Google Scholar 

  30. Gastrointestinal Tumor Study Group. Adjuvant therapy of colon cancer—results of a prospectively randomized trial. N Engl J Med 310:737–743, 1984

    Google Scholar 

  31. Higgins GA Jr., Amadeo JH, McElhinney J, McCaughan JJ, Keehn RJ: Efficiency of prolonged intermittent therapy with combined 5-fluorouracil and methyl-CCNU following resection for carcinoma of the large bowel: A Veterans Administration Surgical Oncology Group Report. Cancer 53:1–8, 1984

    PubMed  Google Scholar 

  32. Engstrom PF, Lavin, PT, Douglass HO Jr, Brunner KW: Post-operative adjuvant 5-fluorouracil plus methyl-CCNU therapy for gastric cancer patients. Eastern Cooperative Oncology Group Study (EST3275). Cancer 55:1868–1873, 1985

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Levendoglu, H., Cox, C.A. & Nadimpalli, V. Composite (Adenocarcinoid) tumors of the gastrointestinal tract. Digest Dis Sci 35, 519–525 (1990). https://doi.org/10.1007/BF01536929

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01536929

Key words

Navigation