Results: Patients with stage I and II disease (T1-4 N0) and TSR-high showed significantly better 5 year survival rates for overall survival compared to TSR-low and TSR-moderate (p=0.010) and a trend to a better disease specific survival (p=0.067) and disease free survival (0.057). In a multivariate Cox regression analysis the TSR remained an independent prognostic factor for overall survival, when adjusted for age, pT-status and grading. Conclusion: TSR as a prognostic tumor characteristic can be used to identify patients with a good and a poor outcome in lymph node metastasis negative cases. Objective: Goblet cell carcinoid (GCC) of appendix vermiformis is a rare neoplasm that share histological features of both adenocarcinoma and carcinoid tumor. While its malignant potential remains unclear, GCC's particularly show transmural dissemination and are more aggressive than conventional carcinoids. Patients usually present with acute appendicitis. They usually lack the formation of a well-defined tumor mass; thus, it is somewhat difficult to accurately assess their size. Method: Case Presentation: Fifty years old male patient applied to the emergency service with abdominal pain and laparatomy was performed with suspicion of acute appendicitis. Grossly, conjestion and exudation on the distal edge of appendectomy material were seen. A 1×1 cm lesion which was spreading into peripheral adipose tissue was seen on the cut surface. Microscopically, tumor was composed of goblet cell groups resembling "signet ring cells". Tumor was infiltrated into muscularis propria and mesoappendix. Immunohistochemically, chromogranin, synaptophysin, cytokeratin 20, mCEA and p53 were stained positive. Ki67 (MIB 1) proliferation index was 18 %. Conclusion: Adenocarcinoid of the appendix is a rare tumor, which is very difficult to diagnose preoperatively and even macroscopically, making histological examination essential. Immunohistochemical staining is required for definitive and differential diagnosis. Here, we present this rare case with literature reviewed.