Abstract
A 79-year-old woman was admitted to our hospital because of abdominal pain and vomiting on an emergency basis. Abdominal CT scan showed wall thickening of the ileum and dilatation of the proximal portion of small bowel to the thickening. An ileal tumor and intestinal obstruction caused by it were suspected. Various examinations failed to make definite diagnosis. Laparoscopy-assisted surgery was thus employed because the tumor might cause intestinal obstruction and we needed to make the definite diagnosis. Laparoscopy-assisted partial resection of the ileum including the ileal tumor and regional mesenteric lymph nodes dissection were successfully performed. The tumor was macroscopically localized in the ileum and no metastasis was observed in other organs.
The tumor was pathologically diagnosed as enteropathy-type T-cell lymphoma (ETL) and no metastasis in the regional mesenteric lymph nodes was observed. The patient has been doing well with no evidence of recurrence for 1 year and a half postoperatively, although we did not employ adjuvant chemotherapy for two reasons. One was that the tumor was localized in the intestine and the curative resection could be achieved ; the other was that the standardized treatment for ETL has not been established as yet.
Laparoscopic surgery could be very useful not only for the diagnosis of the small bowel tumors but also for their treatment.
