Irish Journal of Medical Science

, Volume 180, Issue 4, pp 897–900 | Cite as

Three synchronous gastrointestinal tumours

  • B. M. Boland
  • C. G. Collins
  • E. Christiansen
  • A. O’Brien
  • J. DuignanEmail author
Case Report


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.


Mucinous cystadenoma Appendix Meckel’s Diverticulum Adenocarcinoma Synchronous tumours Carcinoid 



No source of support in the form of grants, equipment, drugs or all of these was received in the writing of this article.


  1. 1.
    Nies C, Zielke A, Hasse C, Ruschoff J, Rothmund M (1992) Carcinoid tumors of Meckel’s diverticula. Report of two cases and review of the literature. Dis Colon Rectum 35(6):589–596. doi: 10.1007/BF02050541 PubMedCrossRefGoogle Scholar
  2. 2.
    Sutter PM, Canepa MG, Kuhrmeier F, Marx A, Martinoli S (1997) Carcinoid tumor in Meckel’s diverticulum: case presentation and review of the literature. Schweiz Med Wochenschr Suppl 89:20S–24SPubMedGoogle Scholar
  3. 3.
    Weber JD, McFadden DW (1989) Carcinoid tumors in Meckel’s diverticula. J Clin Gastroenterol 11(6):682–686. doi: 10.1097/00004836-198912000-00018 PubMedCrossRefGoogle Scholar
  4. 4.
    Grossmann I, Akkersdijk GJ (2003) Carcinoid tumor in a Meckel’s diverticulum: hypothesis on mutual embryological origin. Int Surg 88(1):41–46PubMedGoogle Scholar
  5. 5.
    Habal N, Sims C, Bilchik AJ (2000) Gastrointestinal carcinoid tumors and second primary malignancies. J Surg Oncol 75(4):310–316. doi:10.1002/1096-9098(200012)75:4<306::AID-JSO14>3.0.CO;2-3PubMedCrossRefGoogle Scholar
  6. 6.
    Kothari T, Mangla JC (1981) Malignant tumors associated with carcinoid tumors of the gastrointestinal tract. J Clin Gastroenterol 3(Suppl 1):43–46. doi: 10.1097/00004836-198100031-00009 PubMedCrossRefGoogle Scholar
  7. 7.
    Lo NS, Sarr MG (2003) Mucinous cystadenocarcinoma of the appendix. The controversy persists: a review. Hepatogastroenterology 50(50):432–437PubMedGoogle Scholar
  8. 8.
    Barry M, Collins CG, McCawley N, McGuinness J, Leahy AL (2007) Synchronous appendiceal tumours. Surgeon 5(2):111–113PubMedCrossRefGoogle Scholar
  9. 9.
    Shebani KO, Souba WW, Finkelstein DM, Stark PC, Elgadi KM, Tanabe KK, Ott MJ (1999) Prognosis and survival in patients with gastrointestinal tract carcinoid tumors. Ann Surg 229(6):815–821. doi: 10.1097/00000658-199906000-00008 discussion 822–813PubMedCrossRefGoogle Scholar
  10. 10.
    Modlin IM, Lye KD, Kidd M (2003) A 5-decade analysis of 13, 715 carcinoid tumors. Cancer 97(4):934–959. doi: 10.1002/cncr.11105 PubMedCrossRefGoogle Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2009

Authors and Affiliations

  • B. M. Boland
    • 1
  • C. G. Collins
    • 1
  • E. Christiansen
    • 1
  • A. O’Brien
    • 2
  • J. Duignan
    • 1
    Email author
  1. 1.Department of SurgerySt Michaels HospitalDun LaoghaireIreland
  2. 2.Department of PathologySt Michaels HospitalDun LaoghaireIreland

Personalised recommendations