Epidemiology of Small Bowel Carcinoids in a Defined Population

World J Surg (2010) 34:1500–1505 DOI 10.1007/s00268-010-0519-z Epidemiology of Small Bowel Carcinoids in a Defined Population • • Kalle Landerholm Sture Falkmer Johannes Ja ¨ rhult Published online: 17 March 2010 Socie ´te ´ Internationale de Chirurgie 2010 Abstract Conclusions In comparison to previous reports, a higher Background This retrospective study describes the epi- age-adjusted incidence of small bowel carcinoids was demiology of small bowel carcinoids in a geographically observed, and the patients were clearly older at the time of defined population, with no other selection bias. diagnosis. Even with metastatic disease, the presenting Methods All patients (n = 145) resident in Jo ¨ nko ¨ ping symptoms were usually uncharacteristic, and the carcinoid County when diagnosed with carcinoid in the jejunum or syndrome was infrequently seen. ileum from 1960 to 2005 were included. Medical records were reviewed in detail, and tumor specimens were Introduction histopathologically and immunohistochemically reexam- ined when required (n = 44). Carcinoids are the most common tumors of the small bowel Results The annual age-adjusted incidence of small [1–3], with the reported incidence of jejunal and ileal bowel carcinoids was 1.12 (95% confidence interval 0.95– 1.31) per 100,000 persons. Median age at diagnosis was carcinoids usually varying between 0.3 and 0.7 per 100,000 persons per year [4–8]. However, in a classic autopsy study 69 years. The predominating presenting symptom was uncharacteristic abdominal pain (50%), whereas a smaller [9], a much higher incidence (5.4 per 100,000 persons per year) was found, reflecting the frequency of missed diag- number suffered from typical flushes (13%). Surprisingly, 14% presented with overt gastrointestinal hemorrhage. nosis and subclinical disease, meaning that many patients die with rather than of their tumors. Patients with small...