Neuroendocrine Tumors of Meckel’s Diverticulum: Lessons from a Single Institution Study of Eight Cases
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Endocrine tumors of Meckel’s diverticulum are rare. Their clinical and pathological characteristics are not well known, making it difficult to assess the best strategy for therapeutic management.
Materials and Methods
Eight cases of endocrine tumors of Meckel’s diverticulum, submitted to surgical resection in our institution between 1977 and 2009, were studied. Clinical charts were reviewed; classification, grading, and staging were performed according to recent international recommendations. Five cases, including two associated with the carcinoid syndrome, were revealed by mesenteric mass or liver metastases; three cases were diagnosed incidentally at laparotomy or laparoscopy.
All cases presented as typical well-differentiated midgut endocrine tumors. Five cases were associated with mesenteric lymph node metastases; three presented with liver metastases. Seven cases were classified as well-differentiated endocrine carcinomas, one as well-differentiated endocrine tumor of benign behavior.
All tumors >1 cm, but one, had regional or distant disease. All patients had complete surgical resection of the primary. One patient deceased after 25 months; the others were alive after 12–101 months.
In conclusion, endocrine tumors of Meckel’s diverticulum are rarely symptomatic and often diagnosed at an advanced stage. All tumors measuring more than 1 cm in diameter must be resected according to oncological principles.
KeywordsNeuroendocrine tumors Meckel’s diverticulum Surgery Pathology Carcinoid syndrome
- 4.Solcia E, Klöppel G, Sobin L. Histological typing of endocrine tumours. 2nd edition. New York:Springer, 2000Google Scholar
- 5.Rindi G, Kloppel G, Alhman H, Caplin M, Couvelard A, de Herder WW, Erikssson B, Falchetti A, Falconi M, Komminoth P, Korner M, Lopes JM, McNicol AM, Nilsson O, Perren A, Scarpa A, Scoazec JY, Wiedenmann B. TNM staging of foregut (neuro)endocrine tumors: a consensus proposal including a grading system. Virchows Arch 2006;449:395–401.PubMedCrossRefGoogle Scholar
- 6.Rindi G, Kloppel G, Couvelard A, Komminoth P, Korner M, Lopes JM, McNicol AM, Nilsson O, Perren A, Scarpa A, Scoazec JY, Wiedenmann B. TNM staging of midgut and hindgut (neuro) endocrine tumors: a consensus proposal including a grading system. Virchows Arch 2007;451:757–762.PubMedCrossRefGoogle Scholar
- 7.Sobin LH, Gospodarowicz MK, Wittekind C. TNM Classification of Malignant Tumours, 7th Edition. New York: Wiley, 2009.Google Scholar
- 19.Rasmussen OO, Rafiolsadat Z, Berg J. Carcinoid and pancreas tissue in a macroscopically normal Meckel’s diverticulum. Ugeskr Laeger 1987;83:2538.Google Scholar
- 23.Plockinger U, Couvelard A, Falconi M, Sundin A, Salazar R, Christ E, de Herder WW, Gross D, Knapp WH, Knigge UP, Kulke MH, Pape UF. Consensus guidelines for the management of patients with digestive neuroendocrine tumours: well-differentiated tumour/carcinoma of the appendix and goblet cell carcinoma. Neuroendocrinology 2008;87:20–30.PubMedCrossRefGoogle Scholar
- 24.Eriksson B, Kloppel G, Krenning E, Ahlman H, Plockinger U, Wiedenmann B, Arnold R, Auernhammer C, Korner M, Rindi G, Wildi S. Consensus guidelines for the management of patients with digestive neuroendocrine tumors-well-differentiated jejunal-ileal tumor/carcinoma. Neuroendocrinology 2008;87:8–19.PubMedCrossRefGoogle Scholar
- 26.Eriksson B, Kloppel G, Krenning E, Ahlman H, Plockinger U, Wiedenmann B, Arnold R, Auernhammer C, Korner M, Rindi G, Wildi S. Consensus guidelines for the management of patients with digestive neuroendocrine tumors—well-differentiated jejunal–ileal tumor/carcinoma. Neuroendocrinology 2008;87:8–19.PubMedCrossRefGoogle Scholar
- 27.Silk YN, Douglass HO Jr, Penetrante R. Carcinoid tumor in Meckel’s diverticulum. Am Surg 1988;83:664–667.Google Scholar