Mesenteric Neuroendocrine Tumor Presenting as Ileal Stricture and Acute Small Bowel Obstruction: A Case Report
Swarnava Chanda *
Department of Surgical Oncology, AIIMS Raipur, Chhattisgarh, India.
Aman Prakash
Desun Cancer Institute, Kolkata, West Bengal, India.
Saumitra Mahendra
Department of Pathology, LPS Institute of Cardiology, Kanpur, Uttar Pradesh, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Neuroendocrine tumors (NETs) are uncommon neoplasms arising from the neuroendocrine cells distributed throughout the body. These cells are most frequently found in the gastrointestinal tract. Mesenteric NETs are extremely rare and may present with features of small bowel obstruction due to fibrotic or desmoplastic reactions.
Case Presentation: A 72-year-old male, known diabetic, presented with abdominal distension and obstipation for three days. Imaging revealed multiple air-fluid levels and a mesenteric soft-tissue mass with distal ileal stricture. Exploratory laparotomy showed dilated proximal small bowel loops and a 5x5 cm greyish-white mesenteric mass encasing the ileocolic artery. Right hemicolectomy with distal ileal resection and ileo-transverse anastomosis was performed with proximal covering ileostomy. Histopathological examination confirmed a well-differentiated neuroendocrine tumor of the mesentery.
Conclusion: Though mesenteric NETs are rare, it should be considered in elderly patients presenting with intestinal obstruction and mesenteric mass. Early diagnosis is important and complete surgical excision remains the cornerstone of management.
Keywords: Mesenteric neuroendocrine tumor, ileal stricture, small bowel obstruction, exploratory laparotomy, right hemicolectomy