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Moments in Surgical History |

Siegfried Oberndorfer and the Evolution of Carcinoid Disease

Irvin M. Modlin, MD, PhD; Michael D. Shapiro, MD; Mark Kidd, PhD; Geeta Eick, PhD
Arch Surg. 2007;142(2):187-197. doi:10.1001/archsurg.142.2.187.
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Siegfried Oberndorfer was born in Munich, Germany, in 1876, studied medicine at the University of Munich, and became the youngest Jewish physician to be appointed to its faculty (1907). His unique observations regarding multiple small-intestinal tumors were presented at the German Pathological Society convention (Dresden, Germany, September 1907), where he coined the term karzinoide and published it in December of the same year. Twenty-two years later (in 1929), he amended this report and suggested that carcinoid tumors might also exhibit malignant features and metastasize. The rise of Nazism led to the termination of his position in 1933, and he “emigrated” to Turkey to serve as the chair of anatomical pathology at the University of Istanbul, Istanbul, Turkey, where he remained until his death in 1944. This exploration of his life and times seeks to give Oberndorfer his well-deserved place in the pantheon of pathology and memorialize his unique observations that led to the discovery of the carcinoid tumor.

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Figure 1.

In September 1907, Siegfried Oberndorfer presented his seminal work on carcinoid tumors at the German Pathological Society meeting in Dresden, Germany, and 3 months later it was published in the Frankfurt Journal of Pathology (frontispiece, top right). He described 6 cases of ileal tumors that grew extremely slowly and did not appear to metastasize. On recognizing that these tumors represented a novel disease entity, he ascribed a name to describe the nature of these tumors, karzinoide, or carcinomalike.

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Figure 2.

A timeline of the evolution of the diagnosis and management of carcinoid tumor disease. WHO indicates World Health Organization; APUD, amine precursor uptake and decarboxylation; 5-HIAA, 5-hydroxyindoleacetic acid; 5-HT, 5-hydroxytryptamine; EC, enterochromaffin; ECL, enterochromaffin-like.

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Figure 3.

Theodor Langhans (1839-1915) (top left) published the first report (1867) of a carcinoid tumor (frontispiece, bottom left). Otto Lubarsch (1860-1933) (bottom right) provided the first detailed pathological description (top right) of carcinoid tumors (1888).

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Figure 4.

Pierre Masson (top right) and Andre Gosset (top left) demonstrated the argentaffin staining properties of carcinoid tumors (frontispiece, top) and proposed that the enterochromaffin cells in the gut formed a diffuse endocrine organ. The first description of this diffuse neuroendocrine system was provided in 1938 by Friedrich Feyrter (bottom right).

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Figure 5.

Siegfried Oberndorfer was responsible for the planning and development of the new Pathological Institute of the Munich-Schwabing Hospital, which he described in 1912 (frontispiece, bottom; floor plan, background). From 1911 to 1933, he served as professor and chair of the Pathological Institute, and in 1915, he served Germany during World War I as an army pathologist (center).

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Figure 6.

In 1933, Siegfried Oberndorfer's career was summarily terminated when the National Socialist German Workers' Party orchestrated the boycott of all Jewish physicians. Kemal Pascha (“Atatürk”) (top center) retained Albert Malche, the former Swiss minister of education, to assist in the reformation of the Turkish University system. To this end, Malche undertook the recruitment of the academic elite purged from German universities; by the close of the war, the University of Istanbul was considered the best German university in the world. In 1933, Malche sent an invitation (top left) to Oberndorfer to serve as chair of general and experimental pathology at the University of Istanbul, where he initially delivered his lectures in German with a translator by his side (bottom right).

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Figure 7.

Siegfried Oberndorfer (top right) died in 1944 at the age of 67 years and was buried at the Sisli cemetery in Istanbul (bottom left). The original autopsy report (background) indicated the cause of death to be a mediastinal mass; in 2004, reexamination of the original tumor specimen at the Yale University School of Medicine confirmed the tumor to be a thymoma (center).

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