リンパ節転移が発見の契機となった回腸カルチノイドの1例

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  • CARCINOID TUMOR OF THE TERMINAL ILEUM DETECTED BY NODAL METASTASIS-REPORT OF A CASE-

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A 66-year-old man was admitted to the hospil because of abdominal pain which was not relieved by medical treatment. Abdominal CT scan, magnetic resonance imaging and selective superior mesenteric arteriogram showed a 3.0×3.0cm mesenteric tumor. An operation was performed with a suspicion of mesenteric tumor. A 1.3×1.3cm ileal tumor existed 40cm apart from the ileocecal valve, and a 3.0×3.0cm mesenteric tumor was seen close to the ileal tumor, which retracted its mesenterium. Pathologically the ileal tumor was diagnosed as carcinoid tumor with the invasion depth of se, and the mesenteric tumor was its metastatic lymph node, with strongly positive reactions in Grimelius and chromogranin stains. Mesenteric fibrosis was seen near the metastatic mesenteric Iymph node. Carcinoid tumors of the terminal ileum are quite rare in Japan. In this case the metastatic lesion which was far larger than the primary lesion presented an opportunity for detecting the primary carcinoid tumor of the terminal ileum. The metastatic lesion also had the retracted mesenterium which is characteristic of metastatic mesenteric lymph node.

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