A CASE OF A 3 -MM ILEAL NEUROENDOCRINE TUMOR WITH DISTANT LYMPH NODE METASTASIS

Abstract

A 53-year-old man was referred to our hospital for evaluation and treatment of an ileal neuroendocrine tumor (NET). Colonoscopy revealed a xanthochromic submucosal tumor of 3 mm in diameter in the terminal ileum. It was diagnosed as NET by histological analysis of a biopsy specimen. Preoperative examinations including contrast-enhanced CT, FDG-PET and small-bowel endoscopy did not reveal synchronous or distant metastatic lesions. As a result, the patient was diagnosed as having clinical stage I (cT1, N0, M0) NET. The patient underwent segmental resection of the ileum with D3 lymph node dissection. Despite the small diameter of the tumor, the final pathological diagnosis was grade 2 ileal NET accompanied by metastasis to the ileocolic lymph nodes (#203). Surgical resection and appropriate lymph node dissection should thus be considered for the treatment of ileal NET, regardless of tumor size.