Three synchronous gastrointestinal tumours.
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.
Boland
B M
BM
Department of Surgery, St Michaels Hospital, Dun Laoghaire, Co Dublin, Ireland. bredanmboland@gmail.com
Collins
C G
CG
Christiansen
E
E
O'Brien
A
A
Duignan
J
J
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000236:Adenoma / Q000473:pathology* / Q000601:surgery; D000368:Aged; D002276:Carcinoid Tumor / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000473:pathology* / Q000601:surgery; D008467:Meckel Diverticulum / Q000473:pathology / Q000601:surgery; D009378:Neoplasms, Multiple Primary / Q000473:pathology* / Q000601:surgery