Elastic Vascular Sclerosis of Mesenteric Artery associated with Carcinoid Tumor: A Case Report

Kenichi Nakamura, Akiyoshi Kanazawa, Nobuhiro Ozaki and Saburo Nagaoka*

Department of Surgery and Pathology*, Shimane Prefectural Central Hospital

A 52-year-old man, twice indicated as having liver nodules and admitted for abdominal pain, lower lumbar pain, and diarrhea, was found to have rebound tenderness at the nodule in the right lower quadrant. Computed tomography showed multiple liver nodules, continuous wall thickening along the small intestine, and lymph node swelling in the mesentery, all hypervascular. Enteral fluoroscopy showed ileal sclerosis, wall roughness, and circular shadowless lesion. The elevated tumor in the terminal ileum was diagnosed preoperatively by biopsy as a carcinoid tumor. Serum 5-HIAA and serotonin were high. Surgery was done due to abdominal pain and diarrhea upon oral intake, and 50 cm of the ischemic sclerotic intestine was resected. The specimen showed multiple yellow elastic hard tumors, diagnosed histologically as carcinoid tumors. The peculiar elastic vascular sclerosis in the mesenteric artery was also detected in the ischemic lesion of the ileum.

Key words
carcinoid tumor, small intestine, elastic vascular sclerosis

Reprint requests
Kenichi Nakamura Department of Surgery, Shimane Prefectural Central Hospital
4-1-1 Himebara-cho, Izumo, 693-8555 JAPAN

Accepted
January 28, 2004

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