Synchronous tumor duplicity of a neuroendocrine tumor of Meckel’s diverticulum with liver metastases and colorectal carcinoma
Authors:
B. Tolmáči 1; J. Klein 1,2; P. Žuffa 1; M. Pospíšková 3; A. Řehulková 1,4; M. Piter 1
Authors place of work:
Chirurgické oddělení, Krajská nemocnice T. Bati, Zlín
1; Fakulta zdravotníctva, Trenčianská Univerzita Alexandera Dubčeka, Trenčín
2; Onkologické oddělení, Krajská nemocnice T. Bati, Zlín
3; Ústav molekulární a translační medicíny Lékařské fakulty Univerzity Palackého v Olomouci
4
Published in the journal:
Rozhl. Chir., 2021, roč. 100, č. 9, s. 452-458.
Category:
Case Report
doi:
https://doi.org/10.33699/PIS.2021.100.9.452–458
Summary
Introduction: Meckel’s diverticulum (MD) is a developmental abnormality and a true diverticulum of the small intestine which can give rise to a malignant tumor. Neuroendocrine tumors (NETs) are the most common tumors arising in MD, but due to the prevalence of MD and its malignancy rate, there is no uniform guideline regarding these tumors. Recent knowledge shows that their biological behavior is aggressive and unrelated to size. Their behavior resembles that of an ileal NET.
Case report: A 62-year-old male was examined for enterorrhagia, and an adenocarcinoma of the ascending colon was diagnosed along with multiple liver lesions that resembled metastases. Needle biopsy of a liver lesion was performed and showed the lesions to be NET metastases of unknown origin. Treatment with somatostatin analogs was commenced, and because of the patient’s anemization a right hemicolectomy was indicated, during which a normal Meckel’s diverticulum was found and resected. Histological evaluation of MD confirmed a moderately differentiated NET.
Conclusion: Surgery is the primary modality for treating MD, including cases in which MD is asymptomatic and found incidentally during surgery for other causes. In the case of NET of MD, a radical surgical treatment is needed because of the risk of early metastatic dissemination. When liver metastases are present, an aggressive approach combining surgical and systemic treatment is recommended to improve the prognosis of the disease.
Keywords:
Meckel’s diverticulum – neuroendocrine tumor – prophylactic resection – liver metastases – tumor duplicity
Zdroje
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