Multiple ileal neuroendocrine tumors 10mm in diameter with lymph node metastasis detected on endoscopy:a case report

  • NIMURA Yuho
    Department of Gastroenterology, Kariya Toyota General Hospital
  • HAMAJIMA Eiji
    Department of Gastroenterology, Kariya Toyota General Hospital
  • NAKAE Yasuyuki
    Department of Gastroenterology, Kariya Toyota General Hospital
  • KAMIOKA Tsuguo
    Department of Gastroenterology, Kariya Toyota General Hospital
  • NAKASHIMA Sayori
    Department of Gastroenterology, Kariya Toyota General Hospital
  • KUNO Takeshi
    Department of Gastroenterology, Kariya Toyota General Hospital
  • ITO Makoto
    Department of Pathology, Kariya Toyota General Hospital

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Other Title
  • 内視鏡検査で発見された腫瘍径10mm以下の多発回腸神経内分泌腫瘍の1例

Abstract

<p>A 53-year-old man with an abnormal routine physical examination was referred to our hospital. Colonoscopy showed a 5-mm submucosal tumor that was 7cm proximal to the ileocecal valve. It was identified as a neuroendocrine tumor (NET) on biopsy. Preoperatively, we conducted a double balloon endoscopy to examine the entire small intestine. Another 7-mm submucosal tumor was found on the ileocecal valve, which was missed during the first colonoscopy. A final diagnosis of multiple ileal NETs (<10mm in diameter) was made, and the patient underwent ileocecal resection with lymphadenectomy. Histopathological evaluation of the surgical specimen verified the diagnosis of NET Grade 1 with submucosal invasion. Metastasis to lymph node #202 was also detected. He remained relapse-free for 5 years and 5 months after the operation. In conclusion, this was a case of multiple ileal NETs (<10mm in diameter) with lymph node metastasis that could not be detected preoperatively on contrast-enhanced computed tomography. This case highlights the significance of detailed endoscopic observation of the terminal ileum.</p>

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