What is carcinoid and how to manage it?
Q: I am an NRI currently living in USA. My husband was diagnosed for minute rectal polyp (in anus area) 9 years ago which was removed by external surgery (in India) and was told that the polyp's base was free. After that he was perfectly healthy until last year; he had excruciating lower abdominal pain. CT scan showed a mass measuring 5.4 x 4.2 x 8.2 cms in retrovesical region and the subsequent biopsy report was pararectal mass showing histological and cytological features of a carcinoid tumour (solid pattern). It was removed by surgery here in USA. Though it has been 7 months after surgery, he still experiences moderate pain in pelvic area and constipation once in a while. My question is: What is carcinoid? In his case are there any chances of its recurrence as he is experiencing the same symptoms as before? Kindly advise to prevent recurrence.
A:A carcinoid tumour is a special type of tumour arising from what are called APUD cells in the intestines. It may be benign or malignant. On occasions if incompletely removed or if malignant, it can recur. However, it does not follow that your husbands symptoms after surgery are due to recurrence since symptoms such as occasional constipation and mild pain may be nonspecific and not related to previous disease. However, he would need periodic review with rectal ultrasound and CT and other biochemical investigations depending on whether the carcinoid was reported as benign or malignant. If there is recurrence it has to be dealt with appropriately - with surgery plus chemotherapy.