A Case Report of Small Intestinal Carcinoma Derived from Meckel's Diverticulum

Tomoharu Sugie, Kazuhisa Ohgaki, Norimichi Kan, Souhei Minematsu, Takahiro Shiraishi, Tadao Manabe, Koutarou Uchida, Takayoshi Tobe, Hirohiko Yamabe*, Kiyoyuki Takahashi**

The First Department of Surgery, Kyoto University
*Laboratory of Anatomic Pathology, Kyoto University Hospital
**Pathology, Division of Medical Technology

A case of adenocarcinoma derived from Meckel's diverticulum is reported. A 46-year-old male Caucation was admitted to the hospital with lower abdominal pain. From highly elevated serum CEA level (124 ng/ml), and small intestinal X-ray and selective angiographic findings, he was diagnosed as having ileal cancer. At laparotomy, a tumor (about 2 cm in diameter) was found 60 cm orally from the ileum end in an anti-mesentric portion. In addition, regional and para-aortic lymph nodes showed metastatic swelling. Partial resection of the ileum and partial dissection of the lymph nodes were carried out. Macroscopically, the tumor was covered with normal intestinal mucosa. Pathologic examination revealed a tubular adenocarcinoma producing mucous, infiltrating below the muscularis mucosae, and surrounded by a proper muscle layer, which confirmed that it originated from the diverticulum. After the operation, the patient was treated with chemo-immunotherapy based on an anticancer drug sensitivity assay. He has been alive for about one and a half years.

Key words
small insestinal carcinoma, Meckel's diverticulum

Reprint requests
Tomoharu Sugie Tsukaguchi Prefectural Hospital
6-8-17 Minamitsukaguchi-cho, Amagasaki, 661 JAPAN

Accepted
November 19, 1990

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