Abstract
A 59-year-old woman visited our hospital with a chief complaint of bloody stools, and was diagnosed with rectal cancer. A circumferential type 2 lesion in the upper rectum (Ra), enlarged left supraclavicular fossa lymph nodes, and a lobulated inhomogeneous mass in hepatic segment 5 were noted. A well-defined inhomogeneous mass was also detected at the umbilical level of the abdominal cavity. Lymph gland biopsy, dynamic computed tomography, and fluorodeoxyglucose-positron emission tomography were additionally performed, and synchronous rectal cancer and primary hepatic cancer and intra-abdominal paraganglioma were diagnosed. After hepatic artery embolization, laparotomy was performed. At laparotomy, a white nodule was detected in the mesentery of the jejunum located 60 cm from the ligament of Treitz. It was removed with the small intestine, and lower anterior rectal resection was performed. Based on the pathological examination findings, a diagnosis of well differentiated rectal adenocarcinoma and mesenteric carcinoid tumor (Neuroendocrine tumor: NET G1) was made. A two-stage partial hepatectomy of segment 5 was performed and histopathological examination revealed hepatic metastases from carcinoid tumor. There were no carcinoid tumors in other sites, and primary mesenteric carcinoid was thus diagnosed. Primary mesenteric carcinoid tumor is rare. We report this case and review the relevant literature.
