A Case Report of Adenosquamous Carcinoma with Multiple Cysts of Meckel's Diverticulum

Teiji Takahashi^{1), 4)}, Tadashi Ueda¹⁾, Toyokazu Tamura²⁾, Katsumi Endo²⁾, Taku Ito³⁾, Soroku Yagihashi³⁾

Department of Surgery¹⁾ and Internal Medicine²⁾, Hokushu Central Hospital
The First Department of Pathology, Hirosaki University School of Medicine³⁾
The First Department of Surgery, Akita University School of Medicine⁴⁾

Carcinoma arising in the Meckel's diverticulum is rare, only 28 cases have been described in the literature. We report a case of carcinoma of Meckel's diverticulum, which appeared to derive from the vitello-intestinal duct remnant. A 43-year-old man complained of abdominal discomfort and a mass in the left lower abdomen and was admitted to our hospital. On admission an elastic hard and first-sized mass was palpated in his left lower abdomen. Serum CEA (4.3 ng/ml) and α-fetoprotein (36 ng/ml) levels were elevated. From the above findings in addition to the diagnostic imagings, he was suspected of having a malignant abdominal tumor. An exploratory operation revealed he had the Meckel's diverticulum, located at the ileum about 130 cm from coecum, to which a fist-sized tumor was connected and pushed towards the retroperitoneum through the mesocolon. Extirpation of the tumor including the Meckel's diverticulum together with segmental resection of the sigmoid colon was performed. Microscopic examination revealed that the tumor had arisen in the wall of Meckel's diverticulum with formation of multicystic spaces. Its histology was consistent with adenosquamous carcinoma. Recapitulation to the human vitelline ductlike structure was also present. It was therefore believed that the tumor originated in the vitelline duct remnant incipiently located in the wall of Meckel's diverticulum. The patient was well 7 months after the operation.

Key words
carcinoma of Meckel's diverticulum, adenosquamous carcinoma of the small intestine

Reprint requests
Teiji Takahashi Hokushu Central Hospital
10-5 Hanazono-cho, Takanosu-machi, Kitaakita-gun, Akita, 018-33 JAPAN

Accepted
December 12, 1990

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