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>Journals >Cirugía y Cirujanos >Year 2007, Issue 3


García-Ruiz A, Barrera-Rodríguez FJ, Álvarez-Trasgallo JF, Márquez-García MA
Well-differentiated endocrine carcinoma of the small bowel. Case report and literature review
Cir Cir 2007; 75 (3)

Language: Español
References: 10
Page: 217-221
PDF: 86.02 Kb.

[Full text - PDF]

ABSTRACT

Background: Of all cancers, only 0.3 % are carcinoid tumors of the small bowel. The diagnostic approach of these patients is difficult because they may appear asymptomatic for a long time and also because of the low specificity of the currently available diagnostic tests. We present a case in which the laparoscopic approach allowed not just the diagnosis but facilitated surgery.
Case report: A 58-year-old male had 2 months with midintestinal subocclusive symptoms (late postprandial abdominal pain relieved by vomiting). No abnormalities were found on physical examinations or with laboratory tests. Barium plain x-rays and CT scan revealed a retention stomach and proximal dilation of the small bowel without demonstrating cause. Laparoscopically, we found a 5-cm jejunal tumor. We performed intestinal resection and anastomosis by mini-laparotomy (7 cm). There were no postoperative complications. Pathology report disclosed a well-differentiated neuroendocrine carcinoma. At 1-year follow-up there are no signs of tumor activity.
Conclusions: Laparoscopic surgery contributes to diagnosis and facilitates the management of patients with mid-intestinal subocclusive disease. Due to previous reports, the frequency of small intestine carcinoids may be underestimated. There are carcinoid tumors 2 cm or larger without metastases at the time of diagnosis.


Key words: Carcinoid tumor, diagnostic laparoscopy.


REFERENCES

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  2. 2. Hartel M, Wente M, Bergmann F, et al. Large cell neuroendocrine carcinoma of the major duodenal papilla: case report. Gastrointest Endosc 2004;60:838-841.

  3. 3. Sutcliffe R, Maguire D, Ramage J, et al. Management of neuroendocrine liver metastases. Am J Surg 2004;187:39-46.

  4. 4. Maggard M, O’Connell J, Clifford Y. Updated population-based review of carcinoid tumors. Ann Surg 2004;240:117-122.

  5. 5. Makridis C, Öberg K, Junhlin C. Surgical treatment of mid-gut carcinoid tumors. World J Surg 1990;14:377-383.

  6. 6. Onaitis M, Kirshbom P, Hayward T, et al. Gastrointestinal carcinoids: characterization by site of origin and hormone production. Ann Surg 2000;232:549-556.

  7. 7. Newton J, Swerdlow A, Dos Santos S, et al. The epidemiology of carcinoid tumours in England and Scotland. Br J Surg 1994;70:939-942.

  8. 8. Kelsen D, Daly J, Levin B, Kern S, Tepper J. Gastrointestinal Oncology: Principles and Practice. Philadelphia: Lippincott Williams & Wilkins;2002.

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  10. 10. Norton J, Randal R, Chang A, et al. Surgery. Basic Science and Clinical Evidence. Willard OH: Springer; 2000: pp. 636-637, 919-953.






>Journals >Cirugía y Cirujanos >Year 2007, Issue 3
 

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