Carcinoid tumors of Meckel's diverticula

Nies, C; Zielke, A.; Hasse, C.; Rüschoff, Josef; Rothmund, M

doi:10.1007/bf02050541

Cited by 39 publications

(26 citation statements)

References 45 publications

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“…Individuals most likely to develop complications are those aged 40 years or younger, those with diverticula two centimeters in length or greater, and those containing heterotopic tissue[5]. When complications do present, gastrointestinal bleeding is the most common clinical symptom, generally related to an ulcer caused by secretion from associated gastric mucosa[6]. …”

Section: Introductionmentioning

confidence: 99%

Neuroendocrine Tumors Arising in Meckel's Diverticula: Frequency of Advanced Disease Warrants Aggressive Management

Lorenzen

O’Dorisio

Howe

2013

Journal of Gastrointestinal Surgery

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Background Meckel’s diverticulum is a common anomaly of the GI tract, which occasionally gives rise to cancer. The most frequent tumor affecting these diverticula are neuroendocrine tumors (NETs), and whether these should be treated in similar fashion as small bowel NETs or appendiceal NETs is unclear. Methods A retrospective chart review was conducted at a single academic medical center between 1998–2012. Demographic, radiologic, biochemical, and clinicopathologic data were collected, as well as status at last follow-up. Results Seven patients were identified with NETs involving Meckel’s diverticula, including one with limited information other than the management of her late metastases. Of the 6 other patients, all had involvement of regional nodes, including 3 patients with tumors <2 cm in size, and 4 had liver metastases at presentation. Conclusions NETs in Meckel’s diverticula are rare tumors, but when they develop, are often associated with nodal metastases and liver metastases, even when the tumors are small. Therefore, the optimal management of these NETs is small bowel resection with regional lymphadenectomy, and debulking of liver metastases where feasible.

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Section: Introductionmentioning

confidence: 99%

Neuroendocrine Tumors Arising in Meckel's Diverticula: Frequency of Advanced Disease Warrants Aggressive Management

Lorenzen

O’Dorisio

Howe

2013

Journal of Gastrointestinal Surgery

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“…27 In 1992, Neis et al summarized 104 published cases of Meckel diverticulum cancer (MDC). 13 In their review of 13,715 carcinoids from the Surveillance, Epidemiology, and End Results (SEER) database, Modlin et al observed that 0.48% to 0.74% of all carcinoids in the body occurred in the MD. 28 To the best of our knowledge, there have been no single population-based analysis of the epidemiological and prognostic features of primary MD malignancies.…”

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confidence: 99%

Meckel's Diverticulum—A High-Risk Region for Malignancy in the Ileum

et al. 2011

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Background Surgical management of incidental Meckel’s diverticulum (MD) is a highly debated controversial issue that has never been discussed from the oncological standpoint. Objective To describe the epidemiology and risk of Meckel’s diverticulum cancer (MDC) and compare it with other ileal malignancies. Methods Data were obtained from 163 cases of MDC and 6214 cases of non-Meckelian ileal cancer, between 1973 and 2006, from the Surveillance, Epidemiology, and End Results database. Results Mean annual incidence was 1.44 (± 1.12) per 10 million population, with a 5-fold increase in the last few decades. Incidence increases with age, with a mean age at diagnosis of 60.6 (±15.1) years. Adjusted risk of cancer in the MD was at least 70 times higher than any other ileal site. Disease was localized in 67% at presentation and malignant carcinoids constituted the major histologic type (77%). One-third of patients have had lifetime occurrence of other malignancies and in 13% of these patients, MDC was the first malignancy. Median tumor size was 7 mm. Median overall survival was 173 months (95% confidence interval [CI], 124–221 months), with 1- and 5-year relative survival rates of 85.8% (95% CI, 76.9%-91.4%) and 75.8% (95% CI, 64.9%-83.8%), respectively. Cox proportional hazards model revealed that age, histologic type, and metastatic disease were independent factors affecting survival. Conclusions MD is a “hot-spot” or high-risk area for cancer in the ileum. With risk that increases with age and high possibility of curative resection with negligible operative mortality, incidental MD is best treated with resection.

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“…Similar to the cystadenoma, histological diagnosis was unknown, but carcinoid tumours are the most common malignant tumours of Meckel's diverticulum with two thirds of patients remaining asymptomatic at initial diagnosis [2]. Tumour size influences the likelihood of metastases as does the gender, but with early metastases even in small tumours, aggressive surgical management is justified [1,2,7,9].…”

Section: Discussionmentioning

confidence: 99%

“…Carcinoid tumours are rare, and the presence of a carcinoid tumour in Meckel's diverticulum is so rare, that to date, less than 120 cases have been described in the literature [1,2]. Carcinoid tumours are neuroendocrine tumours originating from the neural crest and can be diagnosed at any age [3].…”

Section: Introductionmentioning

confidence: 98%

Three synchronous gastrointestinal tumours

et al. 2009

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Mucinous cystadenomas of the appendix are rare, with significant malignant potential [Lo and Sarr in Hepatogastroenterology 50(50):432-437, 2003]. Carcinoid tumours are similarly uncommon, rarely occurring in Meckel's diverticula but are still the commonest tumour of Meckel's diverticulae [Nies et al. in Dis Colon Rectum 35(6):589-596, 1992; Modlin and Lye in Cancer 97(4):934-959, 2003; Sutter et al. in Schweiz Med Wochenschr Suppl 89:20S-24S, 1997; Weber and McFadden DW in J Clin Gastroenterol 11(6):682-686, 1989]. A 77-year-old woman presented to our clinic with a 6-week history of non-specific lower abdominal pain. A pelvic ultrasound showed an 8 × 3 × 2.5 cm mass in the right iliac fossa. Colonoscopy and CT confirmed this mass and also revealed a left colonic tumor. At laparotomy, three tumours were identified; in the appendix, a Meckel's diverticulum, and the descending colon. A subtotal colectomy and diverticulectomy were performed. Histology confirmed a T3N0 Dukes B colonic adenocarcinoma, a carcinoid of Meckel's diverticulum and a mucinous adenoma of the appendix. The patient is tumor free to date, 5 years after presentation. The presence of three synchronous tumours of different histological origin in the gastrointestinal tract has not previously been described in the literature.

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Carcinoid tumors of Meckel's diverticula

Cited by 39 publications

References 45 publications

Neuroendocrine Tumors Arising in Meckel's Diverticula: Frequency of Advanced Disease Warrants Aggressive Management

Neuroendocrine Tumors Arising in Meckel's Diverticula: Frequency of Advanced Disease Warrants Aggressive Management

Meckel's Diverticulum—A High-Risk Region for Malignancy in the Ileum

Three synchronous gastrointestinal tumours

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