Yasuda Akira, Kitagami Hidehiko, Kondo Yasuhiro, Nonoyama Keisuke, Watanabe Kaori, Fujihata Shiro, Miyai Hirotaka, Yamamoto Minoru, Shimizu Yasunobu, Tanaka Moritsugu
Department of Surgery, Kariya Toyota General Hospital, 5-15, Sumiyoshi-cho, Kariya, Aichi, 448-8505, Japan.
Clin J Gastroenterol. 2017 Feb;10(1):18-22. doi: 10.1007/s12328-016-0695-y. Epub 2016 Dec 27.
Mesenteric neuroendocrine tumors are usually metastases originating from the small intestine; however, primary mesenteric cases are rare. We present an interesting case of a mesenteric neuroendocrine tumor that changed its internal composition from cystic to solid. A 72-year-old male visited our hospital because of epigastralgia 4 years earlier. A 25-mm tumor was recognized around the terminal duodenum on computed tomography and magnetic resonance imaging, and was diagnosed as a cystic lesion. Over the following 2 years, the tumor grew to 40 mm and its internal composition changed from cystic to solid. The lesion showed positive findings on fluorodeoxyglucose positron emission tomography. Upon laparotomy, a solid tumor was detected in the mesentery of the jejunum near the ligament of Treitz. The tumor was extracted without intestinal resection and was diagnosed as a low-grade neuroendocrine tumor after histopathological and immunohistochemical examination. One year has passed since the operation, and there has been no recurrence.
肠系膜神经内分泌肿瘤通常是源自小肠的转移瘤；然而，原发性肠系膜病例较为罕见。我们报告一例有趣的肠系膜神经内分泌肿瘤病例，其内部成分从囊性转变为实性。一名72岁男性于4年前因上腹部疼痛前来我院就诊。计算机断层扫描和磁共振成像显示十二指肠末端周围有一个25毫米的肿瘤，诊断为囊性病变。在接下来的2年里，肿瘤长至40毫米，其内部成分从囊性转变为实性。该病变在氟脱氧葡萄糖正电子发射断层扫描中显示阳性结果。剖腹探查时，在Treitz韧带附近的空肠系膜中发现一个实性肿瘤。未进行肠切除就将肿瘤摘除，经组织病理学和免疫组织化学检查后诊断为低级别神经内分泌肿瘤。手术已过去一年，未出现复发情况。
