多発肝転移・腸間膜リンパ節転移・腹膜播種を伴った径８ｍｍの回腸カルチノイドの１例

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  • A CARCINOID TUMOR OF THE ILEUM (8mm IN DIAMETER) PRESENTED WITH MULTIPLE LIVER AND NODAL METASTASES WITH PERITONEAL DISSEMINATION-REPORT OF A CASE-

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A 48-year-old woman admitted to the hospital because of persisting diarrhea was found to have a mesenteric mass 6cm in size and more than 50 liver tumors 3-15mm in longer diameter by abdominal CT scan. Puncture of the liver tumors provided the histopathological diagnosis of carcinoid tumor. Laparotomy disclosed numerous peritoneal disseminations. The mesenteric tumor 6cm in diameter was seen, which retracted its mesenterium. An ileocecal resection was performed because the mesenterium was retracted widely. The primary tumor was present in the ileum which was 8×8mm in diameter and like Ila type and was diagnosed as carcinoid tumor with the invasion depth of mp pathologically. The mesenteric tumor was metastatic lymph node associated with fibrosis around it.<br> In Japan carcinoid tumors of the small intestine are rare, but they metastasize in a high frequency. This case of small intestinal carcinoid tumor, which had large metastatic lymph node, multiple metastatic liver tumors, and peritoneal dissemination despite the small primary lesion 8mm in diameter, is very rare. Multidisciplinary treatment is expected to be established for such cases in future.

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