Taki Masataka, Nitta Toshikatsu, Kubo Ryutaro, Yoshiyama Aki, Yoshimoto Hidero, Ishii Masatsugu, Ishibashi Takashi, Takeshita Atsushi
Medico Shunju Shiroyama Hospital, Habikino, Osaka, Japan.
J Investig Med High Impact Case Rep. 2025 Jan-Dec;13:23247096241299286. doi: 10.1177/23247096241299286. Epub 2025 Mar 24.
Neuroendocrine cells are distributed throughout the body's organs, though neuroendocrine neoplasms are primarily documented in the gastrointestinal tract and pancreas, with rare occurrences elsewhere. Herein, we report a case of primary neuroendocrine tumor of the omentum (omental NET) that was incidentally detected as an omental mass during preoperative screening for colorectal cancer. The patient, a 66-year-old woman, with abdominal pain and decreased oral intake, leading to a diagnosis of obstructive colorectal cancer with a large, 55 mm, mass around the gastropyloric region, which was discontinuous with the gastrointestinal tract. After the placement of a colonic stent at the site of the ascending colon cancer to decompress the colon, a laparoscopic right hemicolectomy was performed, simultaneously excising the mass. Postoperative pathology revealed a neuroendocrine tumor (NET). Subsequent examinations detected no other lesions of suspected primary disease and postoperative somatostatin scintigraphy found no other lesions, establishing a diagnosis of omental NET. The rarity of omental NETs is attributable to the absence of neuroendocrine cells in the omentum. Moreover, solid tumors originating primarily from the omentum are very rare, making preoperative diagnosis difficult; therefore, postoperative pathology should be utilized. We presented a very rare case of omental NET, previously reported only once in the literature, and believe that complete resection with minimal invasiveness should be performed for treatment of this malignancy. In addition, we emphasize the need for continued patient follow-up.
神经内分泌细胞分布于全身各器官,不过神经内分泌肿瘤主要见于胃肠道和胰腺,在其他部位较为罕见。在此,我们报告一例大网膜原发性神经内分泌肿瘤(大网膜神经内分泌肿瘤),该病例在结直肠癌术前筛查时偶然被发现为大网膜肿物。患者为一名66岁女性,有腹痛和经口摄入量减少症状,诊断为幽门区有一55毫米大的肿块导致的梗阻性结直肠癌,该肿块与胃肠道不连续。在升结肠癌部位放置结肠支架以解除结肠梗阻后,进行了腹腔镜右半结肠切除术,同时切除了肿块。术后病理显示为神经内分泌肿瘤(NET)。后续检查未发现其他疑似原发性疾病的病变,术后生长抑素闪烁显像也未发现其他病变,从而确诊为大网膜神经内分泌肿瘤。大网膜神经内分泌肿瘤罕见的原因是大网膜中不存在神经内分泌细胞。此外,主要起源于大网膜的实体瘤非常罕见,术前诊断困难;因此,应采用术后病理检查。我们报告了一例非常罕见的大网膜神经内分泌肿瘤病例,此前文献中仅报道过一次,我们认为对于这种恶性肿瘤应进行微创完全切除治疗。此外,我们强调需要对患者进行持续随访。