Synchronous association of rectal adenocarcinoma and three ileal carcinoids: a case report

Seamus M Mchugh,Peter Gillen,Jill O'Donnell

doi:10.1186/1477-7819-7-21

Seamus M Mchugh, Peter Gillen + Show 1 more

Open Access

https://doi.org/10.1186/1477-7819-7-21

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Abstract

BackgroundSynchronous midgut carcinoids with gastrointestinal adenocarcinoma are a rare but recognised association.Case presentationThe patient, a 74 year old woman, underwent anterior resection for a low rectal adenocarcinoma. Intra-operatively 3 serosal deposits of tumour were noted in the distal ileum. Histology revealed these to be ileal carcinoids.ConclusionDuring resection of a gastrointestinal tumour, a thorough inspection of the abdominal cavity should be undertaken to investigate the possibility of metastatic secondaries or a synchronous tumour as is reported in this case.

Highlights

Synchronous midgut carcinoids with gastrointestinal adenocarcinoma are a rare but recognised association.Case presentation: The patient, a 74 year old woman, underwent anterior resection for a low rectal adenocarcinoma
During resection of a gastrointestinal tumour, a thorough inspection of the abdominal cavity should be undertaken to investigate the possibility of metastatic secondaries or a synchronous tumour as is reported in this case
We present the case of a 74 year old woman who underwent elective anterior resection for a high rectal adenocarcinoma with the incidental discovery of 3 ileal carcinoids during her surgery

Summary

Background

The natural history of midgut carcinoid tumours is to progress slowly, arising from neuro-endocrine cells that line the tract. They often present with metastasis at diagnosis and occur most frequently in the ileum (52%) and the appendix (22%) [1]. We present the case of a 74 year old woman who underwent elective anterior resection for a high rectal adenocarcinoma with the incidental discovery of 3 ileal carcinoids during her surgery. Staging abdomino-pelvic CT & MRI scans confirmed a 6.5 × 4 cm T3N1 irregular low rectal mass lesion extending inferiorly with involvement of the muscularis and serosa (figure 1), but no distal metastasis or small bowel pathology (figure 2). World Journal of Surgical Oncology 2009, 7:21 http://www.wjso.com/content/7/1/21

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Jenson RT