Deng Cheng, Su Jin
Department of General Surgery, Medical Center of Digestive Disease, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, China.
Department of Teaching, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, China.
Medicine (Baltimore). 2025 May 2;104(18):e42395. doi: 10.1097/MD.0000000000042395.
Small bowel neuroendocrine tumors (SBNETs) often present with nonspecific clinical manifestations, which can complicate diagnosis and treatment when coexisting comorbidities in the perioperative period. This report discusses a rare case involving SBNETs associated with scoliosis, aiming to provide a comprehensive understanding of the epidemiological characteristics, clinicopathologic features, and treatment strategies related to SBNETs.
A 69-year-old male presented with a 10-month history of abdominal pain, nausea, vomiting, and weight loss. He had been admitted to the other medical institutions multiple times due to recurrent abdominal pain and was diagnosed with small bowel obstruction over the past 10 months. He had a history of scoliosis. Radiographic spine imaging revealed severe scoliosis. At the same time, contrast-enhanced abdominal CT scans indicated slight thickening and enhancement of the small intestinal wall and identified a mass in the mesentery. An enteroscopy did not reveal any significant abnormalities.
Histopathological examination of the tumor specimens confirmed the diagnosis of a small bowel neuroendocrine tumor.
The case was reviewed in a multidisciplinary team discussion, which led to the decision for an exploratory laparotomy. During the surgical procedure, a segment of the small intestine and the associated regional mesenteric lymph nodes were successfully resected.
The patient had an uneventful recovery after surgery, and a follow-up 6 months later showed no signs of recurrence.
Contrast-enhanced abdominal CT is pivotal in the preoperative diagnosis and perioperative staging of SBNETs. Surgical resection remains the gold standard for treatment. In special cases when coexisting with comorbidities such as scoliosis, an individualized treatment strategy should be made after being reviewed by a multidisciplinary discussion.
小肠神经内分泌肿瘤（SBNETs）通常表现为非特异性临床表现，在围手术期合并其他疾病时，会使诊断和治疗变得复杂。本报告讨论了一例罕见的与脊柱侧弯相关的SBNETs病例，旨在全面了解与SBNETs相关的流行病学特征、临床病理特征及治疗策略。
一名69岁男性，有10个月的腹痛、恶心、呕吐及体重减轻病史。因反复腹痛多次入住其他医疗机构，在过去10个月中被诊断为小肠梗阻。他有脊柱侧弯病史。脊柱影像学检查显示严重脊柱侧弯。同时，腹部增强CT扫描显示小肠壁轻度增厚和强化，并在肠系膜中发现一个肿块。肠镜检查未发现任何明显异常。
肿瘤标本的组织病理学检查确诊为小肠神经内分泌肿瘤。
该病例在多学科团队讨论中进行了评估，决定进行剖腹探查术。手术过程中，成功切除了一段小肠及相关区域的肠系膜淋巴结。
患者术后恢复顺利，6个月后的随访未发现复发迹象。
腹部增强CT在SBNETs的术前诊断和围手术期分期中至关重要。手术切除仍然是治疗的金标准。在与脊柱侧弯等合并症共存的特殊情况下，应在多学科讨论评估后制定个体化治疗策略。
