Mussan-Chelminsky Gil, Vidal-González Pablo, Núñez-García Edgar, Valencia-García Luis César, Márquez-Ugalde Miguel Ángel
Servicio de Cirugía General, Centro Médico ABC, México D.F., México.
Servicio de Cirugía General, Centro Médico ABC, México D.F., México.
Cir Cir. 2015 Sep-Oct;83(5):438-41. doi: 10.1016/j.circir.2015.05.047. Epub 2015 Aug 28.
Carcinoid of the small intestine, is a well-differentiated neuroendocrine tumor that rarely presents with clinical signs. This tumour can be associated with other conditions, such as inflammatory bowel disease, presenting a wide range of symptoms. In some cases they have an aggressive and highly symptomatic behaviour; thus, clinical suspicion must be high to make an early diagnosis.
A 60 year-old male patient with Crohn's disease and gastrointestinal symptoms attributed to this disease within the last year. He presented with intestinal obstruction initially treated with conservative management with no improvement. Exploratory laparotomy was performed finding a mesenteric tumour that caused the bowel obstruction. Bowel resection with primary anastomosis was performed. The pathology report showed an intestinal carcinoid tumour with lymph node metastases. The patient recovered well, and was discharged without complications to continue medical treatment and follow-up by the Oncology department.
In almost 42% of the cases, the most common site of carcinoid tumours is the small intestine, and of these, 41% are presented as locoregional disease. Patients with Crohn's disease present a higher incidence. In these cases, the most common presentation is an acute intestinal obstruction (90%). Surgery is usually curative, and follow up is important as the symptoms of Crohn's disease can hide any recurrence.
小肠类癌是一种分化良好的神经内分泌肿瘤,很少出现临床症状。该肿瘤可与其他疾病相关,如炎症性肠病,表现出广泛的症状。在某些情况下,它们具有侵袭性且症状严重;因此,必须高度怀疑以进行早期诊断。
一名60岁男性患者,患有克罗恩病,过去一年出现归因于该疾病的胃肠道症状。他最初表现为肠梗阻,接受保守治疗但无改善。进行了剖腹探查术,发现一个导致肠梗阻的肠系膜肿瘤。进行了肠切除并一期吻合。病理报告显示为伴有淋巴结转移的肠类癌肿瘤。患者恢复良好,无并发症出院,继续由肿瘤科进行治疗和随访。
在近42%的病例中,类癌肿瘤最常见的部位是小肠,其中41%表现为局部区域疾病。克罗恩病患者的发病率更高。在这些病例中,最常见的表现是急性肠梗阻(90%)。手术通常可治愈,随访很重要,因为克罗恩病的症状可能掩盖任何复发情况。