A Case of Multiple Small Bowel Carcinoid Tumors Occurring with Ileus

Abstract

A 64-year-old man presented at our hospital with chief complaints of sudden abdominal pain and vomiting. Abdominal computed tomography revealed dilatation of the small intestine and a contrast-enhancing mass in the lumen of the small intestine. Based on these findings, the patient was diagnosed with ileus due to a tumor of the small intestine, and surgery was performed. Intraoperative findings included an obstruction in the ileum about 1 m from the Bauhin valve and dilatation of the small intestine from the site of the obstruction. A mass the size of a chicken egg was also palpable in the retroperitoneum, which suggested lymph node metastasis. A part of the small intestine (50 cm including the site of stricture) was resected. Examination of the resected specimens revealed many elevated white lesions, including a tumor (maximum diameter, 1.5 cm). The mass in the retroperitoneum, which suggested lymph node metastasis, strongly adhered to the surrounding tissue, and therefore, was impossible to remove. The elevated lesions were all diagnosed as carcinoid tumors upon histopathological examination. This report describes a rare case, as well as a review of the literature on multiple carcinoid tumors of the small intestine detected because of ileus.