Small intestinal ulceration secondary to carcinoid tumour arising in a Meckel's diverticulum

Abstract

A solitary small intestinal ulcer associated with a carcinoid tumour in a nearby Meckel's diverticulum was found in a 77 year old man presenting with massive rectal bleeding. Angiography and a radioisotope study localised the bleeding to the ileum. At operation, the Meckel's diverticulum was identified, with bleeding from an ulcer just distal to it. Pathological examination revealed a small carcinoid tumour confined to the Meckel's diverticulum. Close to the opening of the diverticulum, within the ileum, a well demarcated ulcer was present. Histology showed a non-specific ulcer which eroded a large blood vessel. This is the first documented occurrence of solitary small intestinal ulceration in association with a carcinoid tumour. Carcinoid tumour should be added to the list of possible causes of small intestinal ulceration. The ulceration may be secondary to release of cytokines by the tumour. (J Clin Pathol 1999;52:72-74)

Carcinoid tumors are 15 times more common in patients with Crohnʼs disease

“…Kasprzak et al reported the coexpression of IL‐2 and IL‐12 in 12 of 13 lung carcinoid tumors and theorized that both may play a role in the proliferation of carcinoid tumors 29, 30. Additional cytokines have been found in carcinoid tumors as well 31. Krishnamurthy and Dayal investigated the expression of transforming growth factor‐alpha (TGF‐alpha) and its effect on epidermal growth factor receptor (EGRF) in gastrointestinal carcinoid tumors.…”

An intestinal neuroendocrine tumour associated with paroxysmal ventricular tachycardia and melaena in a 10‐year‐old boxer

“…Anthony and Drury (1970) observed abnormal accumulations of elastin fibres within the intima of mesenteric blood vessels in association with small intestinal carcinoid tumours at distant sites leading to ischaemic necrosis and infarction. Cai and others (1997) observed the production of an angiogenic factor (growth factor α) by neuroendocrine cells, which leads to vascular proliferation (both locally and at distal sites), again potentially leading to gastrointestinal bleeding (McCluggage and others 1999). Finally, circulating vasoactive compounds, such as histamine in dogs (Clemencon and Lawson 1984) and serotonin in man (Ozdemir and others 1972), have been reported as potential inducers of gastric ulceration.…”

Caso Clínico Radiológico: Dolor Abdominal en Adulto Mayor

“…Finalmente, los tumores desarrollados sobre un DM constituyen la complicación menos frecuente que podemos encontrar, aproximadamente 2% de los DM sintomáticos (4) . Entre ellos, se sabe que los tumores malignos son tres veces más frecuentes que los benignos (2) y que, de todas las neoplasias, el tumor carcinoide es el más común; habitualmente único, pequeño y asintomático (1,4,5) . A menudo, dicho tumor se encuentra incidentalmente en el examen histopatológico del DM o en la autopsia y su comportamiento biológico es similar al de los carcinoides ileales.…”