Multifocal neuroendocrine tumour of the small bowel presenting as an incarcerated incisional hernia: a surgical challenge in a high-risk patient
Author(s)
Steinkraus, Kira
Andresen, Julian R
Clift, Ashley K
Liedke, Marc O
Frilling, Andrea
Type
Journal Article
Abstract
Neuroendocrine tumours (NET) of the small bowel present significant clinical challenges, such as their rate of metastasis at initial presentation, common multifocality and understaging even with gold standard imaging. Here, we present a case of a high-risk surgical patient with a complex medical history initially presenting as an acute abdomen due to an incarcerated incisional hernia. He was found at emergency laparotomy to have three small NET deposits in a 30-cm segment of incarcerated ileum which was resected. Postoperative morphological and functional imaging and biochemical markers were unremarkable, but due to clinical suspicion for undetected residual tumour bulk given the non-systematic palpation of the entire small bowel at initial operation, underwent re-operation where a further 70 cm of ileum was found to harbour multiple tumour deposits (n = 25) and was resected. There was no surgical morbidity and the patient remains tumour-free at 9-month follow-up.
Date Issued
2021-06-01
Date Acceptance
2021-05-06
Citation
Journal of Surgical Case Reports, 2021, 2021 (6)
ISSN
2042-8812
Publisher
JSCR Publishing
Journal / Book Title
Journal of Surgical Case Reports
Volume
2021
Issue
6
Copyright Statement
© The Author(s) 2021. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.For commercial re-use, please contact journals.permissions@oup.com
License URL
Sponsor
Dr. Heinz-Horst Deichmann Stiftung
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/34150191
PII: rjab219
Grant Number
n/a
Publication Status
Published
Coverage Spatial
England
Article Number
ARTN rjab219
Date Publish Online
2021-06-16