Fourth Surgical Department, Faculty of Health Science, School of Medicine, Aristotle University of Thessaloniki, "G. Papanikolaou" General Hospital, Thessaloniki 57010, Greece.
Department of Pathology, General Hospital "G. Papanikolaou", Thessaloniki 57010, Greece.
World J Gastroenterol. 2017 Dec 7;23(45):8090-8096. doi: 10.3748/wjg.v23.i45.8090.
Neuroendocrine tumors represent a heterogeneous group of neoplasms that arise from neuroendocrine cells and secrete various peptides and bioamines. While gastrointestinal neuroendocrine tumors, commonly called carcinoids, account for about 2/3 of all neuroendocrine tumors, they are relatively rare. Small intestine neuroendocrine tumors originate from intestinal enterochromaffin cells and represent about 1/4 of small intestine neoplasms. They can be asymptomatic or cause nonspecific symptoms, which usually leads to a delayed diagnosis. Imaging modalities can aid diagnosis and surgery remains the mainstay of treatment. We present a case of a jejunal neuroendocrine tumor that caused nonspecific symptoms for about 1 year before manifesting with acute mesenteric ischemia. Abdominal X-rays revealed pneumatosis intestinalis and an abdominal ultrasound and computed tomography confirmed the diagnosis. The patient was submitted to segmental enterectomy. Histopathological study demonstrated a neuroendocrine tumor with perineural and arterial infiltration and lymph node metastasis. The postoperative course was uneventful and the patient denied any adjuvant treatment.
神经内分泌肿瘤是一组起源于神经内分泌细胞并分泌各种肽类和生物胺的异质性肿瘤。胃肠道神经内分泌肿瘤，通常称为类癌，占所有神经内分泌肿瘤的约 2/3，但它们相对较少见。小肠神经内分泌肿瘤起源于肠嗜铬细胞，占小肠肿瘤的约 1/4。它们可以没有症状，也可以引起非特异性症状，这通常导致诊断延迟。影像学检查可以辅助诊断，手术仍然是治疗的主要手段。我们报告了一例空肠神经内分泌肿瘤的病例，该肿瘤在表现出急性肠系膜缺血之前出现了大约 1 年的非特异性症状。腹部 X 线片显示肠气肿，腹部超声和 CT 证实了诊断。患者接受了节段性肠切除术。组织病理学研究显示神经内分泌肿瘤伴有神经周围和动脉浸润以及淋巴结转移。术后过程顺利，患者否认任何辅助治疗。
