Peritoneal carcinomatosis from a small bowel carcinoid tumour
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Open Access
Case report
Peritoneal carcinomatosis from a small bowel carcinoid tumour Gonzalo Gutierrez*1, Ian R Daniels2, Ana Garcia1 and Jose M Ramia1 Address: 1Hospital Universitario Virgen de las Nieves, Granada, Spain and 2Royal Devon & Exeter Hospital, Exeter, UK Email: Gonzalo Gutierrez* - [email protected]; Ian R Daniels - [email protected]; Ana Garcia - [email protected]; Jose M Ramia - [email protected] * Corresponding author
Published: 03 November 2006 World Journal of Surgical Oncology 2006, 4:75
doi:10.1186/1477-7819-4-75
Received: 21 December 2005 Accepted: 03 November 2006
This article is available from: http://www.wjso.com/content/4/1/75 © 2006 Gutierrez et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Peritoneal carcinomatosis from a gastrointestinal carcinoid tumour is rare and the long-term management and prognosis have not been clearly defined. The natural history is different from gastrointestinal adenocarcinoma, although its capacity to invade regional lymph nodes and generate distal metastasis can make the management more complex. Whilst the development of carcinomatosis is uncommonly reported, it may be higher than expected. Case presentation: A 63 years-old woman underwent emergency surgery in 1993 for right iliac fossa pain and a mass that was found to be an ileal carcinoid tumour. Over the next ten years, further surgery was required for disseminated disease with peritoneal carcinomatosis and liver metastasis. Systemic chemotherapy had little effect, although Somatostatin was used effectively to relieve symptoms caused by the disseminated disease (flushing and diarrhoea). Conclusion: Peritoneal carcinomatosis from carcinoid tumours is not well documented in the literature. Aggressive surgery must be performed in order to control the disease since chemotherapy has not been reported to be effective. With repeated surgery long-term survival can be achieved in these patients.
Background Intestinal carcinoid tumours can be found in all parts of the gastrointestinal tract, with the highest incidence being in the distal ileum. They present as a spectrum from small 'benign' tumours to the classical 'carcinoid syndrome' of local tumour invasion with liver metastases and systemic symptoms. However, compared to adenocarcinoma, they have a better prognosis and long-term survival is reported. This case reports peritoneal dissemination of the carcinoid tumour and a long follow up of the disease.
Case presentation A 63-year old woman presented in 1993 with a short history of right iliac fossa pain, localised peritonitis, and an
elevated white cell count. She reported a two-year history of intermittent colicky abdominal pain. At operation, a 5 cm ileal tumour was found, situated 10 cm proximal from the
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