Simultaneously Performed Laparoscopic Resection of Ileal Ganglioneuroma and Ascending Colon Cancer—Report of a Case—

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  • 上行結腸癌と同時に腹腔鏡下に切除した回腸神経節細胞腫の1例
  • ジョウギョウ ケッチョウ ガン ト ドウジ ニ フククウキョウ カ ニ セツジョ シタ カイチョウ シンケイセツ サイボウ シュ ノ 1レイ

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Abstract

<p>A 68-year-old man presenting with anemia and melena was found having a type 2 tumor at the ascending colon by colonoscopy. A preoperative CT scan revealed not only the ascending colon tumor, but also wall thickening of the terminal ileum which had been demonstrated by a CT scan conducted 8 years previously. An ileal tumor was suspected. Laparoscopic ileocecal excision was thus performed with the diagnosis of ascending colon cancer and an ileal tumor. Operative findings included edematous bowel thickening completely encircling the intestine from about 25 cm to 35 cm from the terminal ileum, in a morphology of a tumor. Grossly the ileal tumor was 90 × 80 mm in size, and on its section, an area from the lamina propria of mucous membrane to the submucosal tissue was white in color and hypertrophied to 15 mm in the maximum diameter. Histopathology revealed proliferation of spindle-shaped Schwann cells and large oval-shaped ganglion cells. Immunostaining resulted in S-100 positive. Accordingly, ganglioneuroma was diagnosed.</p><p>Ganglioneuroma is a benign tumor arisen from the sympathetic ganglion, and ganglioneuroma arisen in the intestine is extremely rare. In a review of the literature, this is the first case of ganglioneuroma without associating with neurofibromatosis type I and/or multiple endocrine neoplasia, and this bowel-derived tumor had largest diameter among those reported so far. In order to establish the therapeutic guidelines including diagnosis and clinical observation, further accumulation of clinical cases would be mandatory.</p>

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