Abstract
A 50-year-old man admitted for a possible recurrent carcinoid tumor involving the hypogastric nerve had undergone low anterior resection preserving the hypogastric nerve 5 years earlier due to a rectal carcinoid 11mm in diameter, initially diagnosed as an endocrine tumor of 40mm located at the bifurcation of the abdominal aorta. Regional lymph node metastasis was observed histologically and the tumor at the bifurcation was a metastatic lymph node. After about 4 years of follow-up he developed severe hypogastric pain. CT and US revealed a tumor involving the hypogastric nerve. We conducted tumor resection under the suspicion of carcinoid tumor recurrent in the anterior floor of the sacrum. Histological findings revealed a carcinoid tumor involving the hypogastric nerve. Initial surgery including resection of the hypogastric nerve may have prevented recurrence, although the patient was only 45 years old at the first surgery. He remains well without recurrence 24 months after the third surgery.
