[Diagnosis and treatment of carcinoids of the large intestine].

A total of 1,279 cases of carcinoids reported in Japan included 882 cases (69.0%) in the digestive organs. Among the latter cases, carcinoids of the large intestine consisted of (A) 320 cases (36.3%) in the rectum and (B) 46 cases (5.2%) in the ileocecal region, cecum and colon excluding the rectum. The predominant difference of signs and symptoms between (A) and (B) was a high incidence of large palpable abdominal tumors and obstructive findings (ileus) in the latter and a high incidence of small-sized tumors and anorectal disturbances such as hemorrhoids, anal bleeding or anal pain in the former. The incidence of the carcinoid syndrome in (B) was 13.0%, considerably higher than the average of the Japanese series (4.1%) and the America-Europe series. Silver impregnation methods with a combination of Grimeluis' argyrophil and Masson-Fontana's argentaffin reactions were considered to be useful methods for diagnosis of carcinoids of the large intestine. The rate of metastasis in relation to tumor size in the Japanese series was 6.1% for lesions less than 1.0 cm in size and 25.7% for lesions between 1.0 and 2.0 cm. Because of a high incidence of metastasis in (B), 41.3%, greater than that for ordinary carcinoma in the identical sites, it was emphasized that surgical treatment of carcinoids of the large intestine should be principally in accordance with that for ordinary carcinomas.