A Case of Colonic Carcinoid that Caused Massive Bloody Stool Induced by Ticlopidine

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  • チクロピジンによると思われる大量下血をきたした大腸カルチノイドの1例

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Abstract

A 55-year-old man was admitted to our hospital accompanied by massive bloody stool. Four years ago the patient was attacked by cerebral infarction, and has been treated with ticlopidine (100mg/day) . We could not find the souce of the hemorrhage by the upper gastrointestinal endoscopy. Colonoscopic finding was a Borrmann 1 type advanced cancer in the ileocecal region. The tumor was histologically diagnosed as carcinonid (mixed type) and the patient underwent an operation of the right half colon resection.<br> The tumor was 4cm×3.5cm in size, with relatively smooth surface. Tumor cells infiltrated to the serosa. Lymph node metastasis were extended to N2. HE stain showed nodular solid nests, partially with trabecular and rosette-like structure. Grimelius arglophil reaction and Fontana-Masson argentaffin reaction were both positive in the tumor.<br> Ileocecal carcinoid is very rare in Japan, compared with western countries and USA. Our review of the literature revealed only 13 cases of ileocecal carcinoid except our case in Japan. Our report was a rare case of cecal carcinoid that seemed to cause massive bleeding due to ticlopidine.

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