Abstract
A 67-year-old man was admitted to our hospital because of abdominal distention and pain. On physical examination, a mass was palpated in the lower abdomen. Ultrasonography, an abdominal CT scan, and magnetic resonance imaging revealed a mesenteric tumor 4.0 cm in diameter, and a superior mesenteric arteriogram showed a hypovascular tumor. Small bowel radiography depicted a submucosal tumor 1.8 cm in diameter with defined margins. At surgery, an ileal tumor was observed, and a mesenteric tumor 4.0 cm in diameter was noted close to the terminal ileum where the mesentery was retracted. Approximately 100 cm of the distal ileum was resected, and examination of the resected specimen revealed 8 ileal tumors ranging in size from 0.2 cm to 1.8 cm. Pathologically, the ileal tumors were diagnosed as carcinoid tumors, with a depth ss, and the mesenteric tuomor was identified as a metastatic lymph node. Chromogranin staining was strongly positive, and electron microscopic examination demonstrated numerous neurosecretory granules. Ileal carcinoid tumor is rare. In this case multiple synchronous tumors were observed, and the mesenteric tumor was much larger than the primary lesion and led to the detection of the primary carcinoid tumor.
