A Case of Rectal Carcinoid 11 mm in Diameter at First Diagnosed as Endocrine Cell Tumor at the Bifurcation of Abdominal Aorta

Hirotoshi Ohta, Makoto Seki¹⁾, Akio Yanagisawa²⁾, Yasuro Ninomiya and Yo Kato³⁾

Gastrointestinal Cancer Center, Kanamecho Hospital
Department of Gastrointestinal Surgery, Ariake Cancer Institute Hospital¹⁾
Department of Pathology, Kyoto Prefectural University of Medicine²⁾
Department of Pathology, Cancer Institute³⁾

A 50-year-old man admitted for a possible recurrent carcinoid tumor involving the hypogastric nerve had undergone low anterior resection preserving the hypogastric nerve 5 years earlier due to a rectal carcinoid 11 mm in diameter, initially diagnosed as an endocrine tumor of 40 mm located at the bifurcation of the abdominal aorta. Regional lymph node metastasis was observed histologically and the tumor at the bifurcation was a metastatic lymph node. After about 4 years of follow-up he developed severe hypogastric pain. CT and US revealed a tumor involving the hypogastric nerve. We conducted tumor resection under the suspicion of carcinoid tumor recurrent in the anterior floor of the sacrum. Histological findings revealed a carcinoid tumor involving the hypogastric nerve. Initial surgery including resection of the hypogastric nerve may have prevented recurrence, although the patient was only 45 years old at the first surgery. He remains well without recurrence 24 months after the third surgery.

Key words
rectal carcinoid, schwannoma, lymph node metastasis of bifurcation of abdominal aorta

Reprint requests
Hirotoshi Ohta Gastrointestinal Cancer Center, Kanamecho Hospital
1-11-13 Kanamecho, Toshima-ku, 171-0043 JAPAN

Accepted
March 22, 2006

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