Abstract:Background. Malignant neoplasms arising in Meckel's diverticulum, a vitelline duct remnant, are rare yet well-documented. Case Presentation. A 53-year-old previously healthy female presented with an enlarging midline abdominal wall mass. A computed tomography scan revealed a mass involving the linea alba, bilateral rectus abdominis, and subcutaneous fat. Extensive clinical workup failed to demonstrate other lesions, except local and paratracheal/hilar lymphadenopathy. Histopathologic examination of the resecte… Show more
“…A literature review revealed no reports of MD adenocarcinoma with an umbilical side of VDR or a huge cystic lesions; our case is therefore considered to be the first one. As for the E type, which occurs in the abdominal wall of the umbilicus, only two cases have been reported [ 8 , 9 ]. Fig.…”
Highlights
Meckel’s diverticulum (MD) is the most common type of vitelline duct remnant (VDR), but MD adenocarcinoma is rare.
We reported a case of MD adenocarcinoma accompanied with the umbilical side of VDR and the huge cystic lesion.
The huge cystic lesion was bloated by tumor components filling up the duct due to cancer progression.
The recognition of tumor development of the embryonic remnant origin is considered important for the treatment of this adenocarcinoma.
“…A literature review revealed no reports of MD adenocarcinoma with an umbilical side of VDR or a huge cystic lesions; our case is therefore considered to be the first one. As for the E type, which occurs in the abdominal wall of the umbilicus, only two cases have been reported [ 8 , 9 ]. Fig.…”
Highlights
Meckel’s diverticulum (MD) is the most common type of vitelline duct remnant (VDR), but MD adenocarcinoma is rare.
We reported a case of MD adenocarcinoma accompanied with the umbilical side of VDR and the huge cystic lesion.
The huge cystic lesion was bloated by tumor components filling up the duct due to cancer progression.
The recognition of tumor development of the embryonic remnant origin is considered important for the treatment of this adenocarcinoma.
BackgroundThe presence of a vitelline vascular remnant is rare, and definitive preoperative diagnosis is difficult. We herein describe a case of intestinal obstruction caused by a vitelline vascular remnant with mild chronic appendicitis successfully diagnosed and treated with laparoscopic surgery.Case presentationA 14-year-old male was admitted to our hospital with sudden-onset right lower abdominal pain and vomiting. A blood test on admission revealed slight leukocytosis. Computed tomography scan showed that the appendiceal wall was enhanced and thickened. Although the ileum was slightly dilated and ascites was present at the recto-vesical pouch, these were thought to be inflammatory changes secondary to appendicitis. Laparoscopic surgery was performed using three trocars. Strangulated small bowel obstruction caused by a band connecting the right medial umbilical fold to the ileal mesentery was found intraoperatively. After reduction, neither ischemic change of the small intestine nor Meckel’s diverticulum was detected. The appendix was slightly inflamed, and serous ascites was present at the recto-vesical pouch; therefore, appendectomy was also performed. The patient was discharged on postoperative day 4 without complications. Pathological examination revealed that the band consisted of blood vessels, and it was diagnosed as a vitelline vascular remnant. The appendix included fecal stones and showed chronic inflammatory change histologically; the patient was thus diagnosed with chronic appendicitis.ConclusionsDefinitive preoperative diagnosis of a vitelline vascular remnant, especially with coexisting appendicitis, might be difficult. Laparoscopic surgery might be useful for patients who demonstrate unusual symptoms because it allows for simultaneous diagnosis and treatment.
DepartmentsofSurgery 1) andPathology 2) ,KyoritsuGeneralHospital Anadultcaseofintestinalobstructioncausedbyavitellinecystisreported.A28-year-oldmanpresentedtoourhospitalbecauseofcontinuousabdominalpainaroundtheumbilicus.Abdominalenhanced computedtomographyshowedmarkeddilatationofthesmallintestineandacysticlesiondirectlyunder theumbilicus.Thecystwasapproximately60mminmaximaldiameter.Thepreoperativediagnosiswas intestinalobstructioncausedbyavitellinecyst.Intraoperatively,thesmallintestinewasseentobeobstructedbyaband-likestructureextendingfromthecysttotheileumoftheoralside，95cmfromtheileocecum.Enblocresectionofthevitellinecystandtheband-likestructurewasperformed.Histological examinationofthespecimenshowedthecompletestructureoftheintestinalwallatthesiteofthevitelline cyst. Meckel's diverticulum is well known as a form of vitello-intestinal duct remnant, but other formsarerareinadults.Thiscaseispresentedalongwithareviewoftheliterature.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
