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RETURN OF THE CARCINOID: A 37 YEAR JOURNEY
Author(s) -
Sharp D. A.,
Mikhail M.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04929_11.x
Subject(s) - medicine , mesentery , exploratory laparotomy , carcinoid tumors , carcinoid tumour , laparotomy , appendix , carcinoid syndrome , rectum , general surgery , surgery , radiology , gastroenterology , pathology , paleontology , biology
Carcinoid tumours are an indolent tumour of neuroendocrine origin, derived from primitive stem cells, most commonly found in the appendix, small bowel and rectum. Most early stage carcinoid tumours can be treated and often cured by surgery, with a 70 to 90 per cent five ‐year survival rate. The long term survival rate of this tumour raises the possibility of remote tumour recurrence. This case study documents the recurrence of small bowel carcinoid following a 37 year interval. An exploratory laparotomy was undertaken on a 70 year old male with radiological evidence of a large 4 cm mesenteric node. Surgery revealed extensive tumour seeding in the peritoneum and mesentery of the small bowel. A small bowel resection was performed including the mass of tissue in adjacent mesentery. Histology confirmed a mass of secondary carcinoid tissue with further deposits of carcinoid tumour in the surrounding nodes, mesentery and appendix. An extensive search of military hospital records showed that the patient had undergone a small bowel resection 37 years earlier of which the histological report at the time confirmed the presence of a small bowel carcinoid tumour. A comprehensive review of the literature has revealed no reportable cases of gastrointestinal carcinoid recurrence after such a long interval of time.