ESDによりカルチノイド症候群が消失した回盲部カルチノイド腫瘍の1例

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  • A case of colonic carcinoid with carcinoid syndrome treated using ESD

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A 75-year-old man underwent total colonoscopy (TCS) after a positive fecal occult blood test, and was diagnosed with submucosal tumor (SMT) in the Bauhin valve. In 2009, the patient had a hot reddish face and easily became angry. In 2010, TCS re-examination showed the enlarged SMT lesion to be approximately 12 mm in size. Laboratory data showed normal serum gastrin and elevated serum serotonin (299 ng/ml) . Abdominal CT scan identified a 12 mm sized enhanced mass on the Bauhin valve. Subsequently, endoscopic submucosal dissection (ESD) of the SMT was performed. Pathological examination was positive for synaptophysin, CD56 and chromogranin, and the results confirmed the diagnosis of neuroendocrine tumor (NET-G1, i.e. carcinoid) . Following ESD, serum serotonin decreased to 133 ng/ml, and the patient’s symptoms of carcinoid syndrome─such as readiness to anger─were gone. In this case we performed ESD to treat colonic carcinoid with carcinoid syndrome. Follow-up shows there have been no signs of recurrence for three years.

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