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Krabbalíki á Íslandi 1955-1984 : yfirlit og umfjöllun um krabbalíki í meltingarfærum utan botnlanga

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Authors
Jón G. Hallgrímsson
Þorvaldur Jónsson
Jóhann Heiðar Jóhannsson
Issue Date
1989-08-15

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Læknablaðið 1989, 75(6):201-8
Abstract
One hundred and forty six carcinoid tumors histologically verified in Iceland during 1955 through 1984 have been analysed as demonstrated in Tables I to II and VI to VII. The crude incidence was 2.41 patients per 100.000 inhabitants per year. In the present report 46 cases of non-appendiceal gastrointestinal carcinoid tumors are further analysed as shown in Tables III to V. Midgut tumors were 29, six of those were located at the ileo-cecal valve and these had the largest average size and highest degree of invasion of all the carcinoid tumors. Fourteen patients (9.7%) developed carcinoid syndrome, when the criteria of flushing and/or diarrhea in a patient with histologically verified carcinoid tumor were applied. Eight of the patients had had symptoms from their tumor from one to seven years before diagnosis and at the first operation they all had metastases. Four of those had carcinoid syndrome. One case of familial occurrence was found, mother and son, and both had ileal primary tumors. By December 1st 1986 eighteen patients (39%) with non- appendiceal gastrointestinal carcinoid tumors had died from the disease.
Árin 1955-1984 voru á Íslandi vefjafræðilega greind krabbalíki (carcinoid tumors) hjá 146 sjúklingum (töflur I, II, VI og VII). Árlegt nýgengi (crude incidence) var 2,41 sjúklingur á 100.000 íbúa. Í greininni er fyrst gefið almennt yfirlit yfir sjúkdóminn, en síðan fjallað um krabbalíki í meltingarfærum utan botnlanga, en þau tilfelli voru samtals 46 (töflur III-V). Þeim er skipt niður í þrjá flokka (tafia II) og gerð er grein fyrir hverjum flokki fyrir sig, stærð æxlanna og vexti er lýst, greint frá klínískum einkennum og aðgerðum. Miðgirnisæxlin voru flest eða 29 og af þeim voru sex staðsett við ristilloka, en þessi æxli voru að meðaltali stærst og ífarandi vöxtur mestur allra krabbalíkisæxlanna. Fjórtán sjúklingar af 144 (9,7%) höfðu krabbalíkisheilkenni (carcinoid syndrome) samkvæmt ákveðnum skilmerkjum. Þar af höfðu 11 krabbalíki í miðgirni og einn í lunga. Átta sjúklingar höfðu haft einkenni frá krabbalíki í eitt til sjö ár áður en æxlið var greint, og við fyrstu skurðaðgerð höfðu þeir allir meinvörp og fjórir krabbalíkisheilkenni. Fjölskyldutengsl komu fram hjá tveimur sjúklingum, móður og syni. Samtals létust 18 manns af völdum krabbalíkis í meltingarfærum á rannsóknartímabilinu eða 39% tilfella, en þá eru botnlangaæxlin ekki talin með.
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