[Well-differentiated endocrine carcinoma of the small bowel. Case report and literature review].
BACKGROUND
Of all cancers, only 0.3% are carcinoid tumors of the small bowel. The diagnostic approach of these patients is difficult because they may appear asymptomatic for a long time and also because of the low specificity of the currently available diagnostic tests. We present a case in which the laparoscopic approach allowed not just the diagnosis but facilitated surgery.


METHODS
A 58-year-old male had 2 months with mid-intestinal subocclusive symptoms (late postprandial abdominal pain relieved by vomiting). No abnormalities were found on physical examinations or with laboratory tests. Barium plain x-rays and CT scan revealed a retention stomach and proximal dilation of the small bowel without demonstrating cause. Laparoscopically, we found a 5-cm jejunal tumor. We performed intestinal resection and anastomosis by mini-laparotomy (7 cm). There were no postoperative complications. Pathology report disclosed a well-differentiated neuroendocrine carcinoma. At 1-year follow-up there are no signs of tumor activity.


CONCLUSIONS
Laparoscopic surgery contributes to diagnosis and facilitates the management of patients with mid-intestinal subocclusive disease. Due to previous reports, the frequency of small intestine carcinoids may be underestimated. There are carcinoid tumors 2 cm or larger without metastases at the time of diagnosis.
Corporativo Hospital Satélite, Circuito Juristas 39-B, esquina Jacinto Pallares, Ciudad Satélite, 53100 Naucalpan, Estado de México. garcia_ruiz@msn.com
Antonio
A
García-Ruiz
Francisco Javier
FJ
Barrera-Rodríguez
José Francisco
JF
Alvarez-Trasgallo
Miguel Angel
MA
Márquez-García
D004701:Endocrine Gland Neoplasms / Q000473:pathology*; D006801:Humans; D007580:Jejunal Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged