2018 Volume 60 Issue 7 Pages 1323-1330
Primary mesenteric neuroendocrine tumors (NETs) are extremely rare. Here we report a case of NET originating from the mesentery, which was diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). A 61-year-old man who was being treated for hypertension, gout, and diabetes in our hospital’s department of metabolic internal medicine, was referred to our department for evaluation of pancreatic cystic lesions. The patient did not present gastrointestinal symptoms. Contrast-enhanced CT incidentally revealed a solid mass of 45 mm in diameter in the lower abdominal mesenterium and lymphadenopathy occurring beside the abdominal aorta. FDG-PET/CT scan revealed significant uptake into the abdominal mass, lymph nodes, left femoral bone, and third lumbar vertebra. Gastrointestinal endoscopy and colonoscopy revealed no abnormal findings. The patient underwent EUS-FNA of the solid mass for histological diagnosis and was diagnosed with NET. Somatostatin receptor scintigraphy showed the absence of primary lesions in other organs. The small intestine was examined by capsule endoscopy, and no tumor was observed. Therefore, the patient was diagnosed with primary mesenteric NET. Given the absence of intestinal obstructions and the presence of metastases in distant lymph nodes and bone, the patient did not undergo surgery and has been on octreotide therapy.
