Ileal Neuroendocrine Tumor in a Patient with Sclerosing Mesenteritis: Which Came First?

Autor: Pathirannehalage Don C; Department of Surgery, Policlinico Tor Vergata, Rome, Italy., Sforza D; Department of Emergency Surgery, Policlinico Tor Vergata, Rome, Italy., Siragusa L; Department of Surgery, Policlinico Tor Vergata, Rome, Italy., Sensi B; Department of Surgery, Policlinico Tor Vergata, Rome, Italy., Ciancio Manuelli M; Department of Emergency Surgery, Policlinico Tor Vergata, Rome, Italy., Telesca R; Department of Histopathology, Policlinico Tor Vergata, Rome, Italy., Savino L; Department of Histopathology, Policlinico Tor Vergata, Rome, Italy., Ferrazzoli V; Neuroradiology Unit, Department of Biomedicine and Prevention, Policlinico Tor Vergata, Rome, Italy., Grande S; Department of Surgery, Policlinico Tor Vergata, Rome, Italy., Villa M; Department of Emergency Surgery, Policlinico Tor Vergata, Rome, Italy., Grande M; Department of Emergency Surgery, Policlinico Tor Vergata, Rome, Italy.
Jazyk: angličtina
Zdroj: The American journal of case reports [Am J Case Rep] 2021 Jun 06; Vol. 22, pp. e931372. Date of Electronic Publication: 2021 Jun 06.
DOI: 10.12659/AJCR.931372
Abstrakt: BACKGROUND Jejunoileal neuroendocrine tumors (JI-NETs) are rare tumors that can be associated with mesenteric fibrosis. This case report is of an incidental finding of a JI-NET in a patient who was previously misdiagnosed with sclerosing mesenteritis. CASE REPORT A 42-year-old man was admitted to our institution with diffuse abdominal pain and clinical and radiographic signs of bowel obstruction. He had a previous diagnosis of sclerosing mesenteritis, which had been histologically diagnosed after an exploratory laparoscopy performed in 2009 for recurrent acute abdominal pain. He was also annually monitored through computed tomography scans for an incidentally discovered, gradually enlarging mesenteric mass for which a "wait and watch" management approach was adopted. After a period of fasting and observation, the patient underwent an urgent exploratory laparotomy because of his worsening condition. Intraoperatively, an ileocecal resection was performed, along with excision of the known mesenteric mass. The pathology report revealed an ileal NET with nodal metastases within the mesentery and mesenteric tumor deposits (pT3N1). CONCLUSIONS JI-NETs are rare entities, which are usually encountered as incidental findings or in patients with unspecific abdominal pain. Our case represents a probable delayed diagnosis of JI-NET in the context of sclerosing mesenteritis; therefore, a possible association between these 2 conditions should be investigated.
Databáze: MEDLINE