A Large Lymph Node Metastasis from a Carcinoid Tumor Treated by Laparoscopic Ileocecal Resection

Abstract

Carcinoid of the small intestine often metastasizes to the lymph nodes, even when the lesions are small. We encountered a case of carcinoid tumor of the ileum, in which the lymph node metastatic tumor was larger than the primary lesion. A 62-year-old man presented to his primary care doctor with a history of constipation and diarrhea. Abdominal CT revealed an ileocecal tumor, and the patient was referred to our hospital. We diagnosed the patient as having an ileocecal mesenteric tumor and performed laparoscopic ileocecal resection with lymph node dissection. However, a carcinoid tumor was found in the terminal ileum, and the ileocecal mesenteric tumor was histopathologically diagnosed as a lymph node metastasis from the carcinoid tumor. The primary and metastatic lesions measured 15 mm and 30 mm in diameter, respectively. In cases of lymph node metastasis from carcinoid tumors of the small intestine, metastatic tumors are not uncommonly larger than the primary lesion. It is important to differentiate such lymph node metastases from mesenteric tumors.