A Patient with Ileal Carcinoids Associated with Radiating Soft Tissue Strands in the Mesenterium

Nobuhiko Ueda,Hideaki Nezuka,Seiichi Yamamoto and Yoshiaki Isobe

Department of Surgery, Maizuru Kyosai Hospital

A patient with ileal carcinoids associated with radiating soft tissue strands in the mesenterium is reported. A 54-year-old man complained of intermmittent abdominal pain. A mass of about 10cm in diameter was palpated in the right lower abdomen on physical examination. Abdominal computed tomography findings revealed a mass 4×2.5×7cm in diameter,enhanced at an early phase in the mesenterium at the terminal ileum with radiating soft tissue strands to the surrounding small bowel loops. Two lesions inside and in the small bowel wall with enhancement and many small lymph nodes in the mesenterium were also seen. Surgery showed a solid mass 8×5×3cm in diameter and many enlarged lymph nodes in the mesenterium at the terminal ileum. The terminal ileum gathered around the mass was resected with enlarged lymph nodes. At the mucosal side of the small bowel of the resected specimen, 1 tumor with a wide stalk about 25mm in diameter and 7 submucosal tumors 3 to 8mm in diameter were also seen.Pathologically, all tumors were carcinoid,and that with the wide stalk invaded the subserosal layer. The mass in the mesenterium consisted of the same tumor cells and was judged to be lymph node metastasis. The patient has been followed up for 1 year with no evidence of recurrence.

Key words
ileal carcinoid, lymph node metastasis of ileal carcinoid, radiating soft tissue strands in the mesenterium

Reprint requests
Nobuhiko Ueda Department of Surgery, Maizuru Kyosai Hospital1035 Hama, Aza, Maizuru, Kyoto, 625-8585 JAPAN

Accepted
June 26, 2001

To read the PDF file you will need Abobe Reader installed on your computer.