腹腔鏡補助下に切除した回腸カルチノイドの１例

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  • A case of carcinoid tumor of the ileum presected by laparoscopy-assisted ileocecal resection.

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A 59-year-old man was admitted to the hospital because of positive fecal occult blood tests. Colonoscopy examination revealed an elevated lesion, 10mm in diameter, in the terminal ileum. A histological diagnosis of carcinoid was made based on a biopsy specimen taken from the lesion. Since no apparent lymph nodes nor distant metastasis was noted, a laparoscopy-assisted ileocecal resection with regional lymph node dissection was performed. On the resected material, a 1.0×0.9cm, oval and demarcated carcinoid tumor limited in the submucosal layer was present lcm to the Bauhin valve of the terminal ileum. It was chromogranin A positive. Histologically, carcinoid tumor, classical type, was diagnosed. Metastasis in the paraileal lymph node was detected. It is said that carcinoid tumor of the ileum prones to metastarize in a high rate even if the tumor is small in diameter and dose not invade the muscularis. Laparoscopy-assisted ileocecal resection with lymph node dissection can be indicated for carcinoid tumor of the ileum end without apparent distant metastases.

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