The majority of the appendiceal carcinoids are localized to the appendix at the time of the diagnosis, behave in an indolent fashion, and cured by simple appendectomy. Five year survival rate is greater than 95%. Tumors larger than 2 cm may spread to the regional lymph nodes, peritoneum, or the mesoappendix (depicted here). Such cases are often treated with a more radical approach consisting of right hemicolectomy. Distant metastases are seen in about 1% of cases. Again, most of these tumors are larger than 2 cm and carcinoid syndrome may be present as well.