A CASE OF CARCINOID OF THE SMALL INTESTINE PRESENTED WITH HEPATIC METASTASIS IN WHICH BOTH PRIMARY AND METASTATIC FOCI WERE RESECTED

Abstract

A 69-year-old woman who had been followed for anemia and a hepatic angioma since June 1997 was admitted to the hospital because of an enlargement of the hepatic angioma and a recently appeared hepatic tumor in June 2000. On admission stool guaiac test was positive, but upper and lower gastrointestinal endoscopies revealed no abnormalities. A needle biopsy of the hepatic tumor offered a suspicion of hepatocellular carcinoma, and surgery was performed on September 12. During surgery a 2 cm-sized tumor was present in the ileum, so that a partial excision of the ileum and a hepatectomy were performed. The pathological diagnosis was carcinoid of the small intestine and its hepatic metastasis. As of 2 years 6 months after the operation, she has not experienced recurrence and is followed in the outpatient clinic.
Carcinoid of the small intestine is accidentally detected and often associated with metastasis in many cases, and accordingly the prognosis is poor. However, there are some reports describing that the patients undergone direct therapy such as surgical excision or intrahepatic arterial infusion therapy are expected to have improved prognosis. In this paper, we present a case of small bowel carcinoid presented with hepatic metastasis in which the primary and metastatic foci could be resected, together with some bibliographical comments.