Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
World Journal of Surgical Oncology
Published in: World Journal of Surgical Oncology 1/2011

Open Access 01-12-2011 | Technical innovations

Partial abdominal evisceration and intestinal autotransplantation to resect a mesenteric carcinoid tumor

Authors: William H Kitchens, Nahel Elias, Lawrence S Blaszkowsky, A Benedict Cosimi, Martin Hertl

Published in: World Journal of Surgical Oncology | Issue 1/2011

Login to get access

Abstract

Background

Midgut carcinoids are neuroendocrine tumors that commonly metastasize to the intestinal mesentery, where they predispose to intestinal obstruction, ischemia and/or congestion. Because of their location, many mesenteric carcinoid tumors are deemed unresectable due to the risk of uncontrollable bleeding and prolonged intestinal ischemia.

Case Presentation

We report the case of a 60-year-old male with a mesenteric carcinoid tumor obstructing his superior mesenteric vein, resulting in intestinal varices and severe recurrent GI bleeds. While his tumor was thought to be unresectable by conventional techniques, it was successfully resected using intestinal autotransplantation to safely gain access to the tumor. This case is the first described application of this technique to carcinoid tumors.

Conclusions

Intestinal autotransplantation can be utilized to safely resect mesenteric carcinoid tumors from patients who were not previously thought to be surgical candidates. We review the literature concerning both carcinoid metastases to the intestinal mesentery and the use of intestinal autotransplantation to treat lesions involving the mesenteric root.
Appendix
Available only for authorised users
Literature
1.
Woodside KJ, Townsend CM, Mark Evers B: Current management of gastrointestinal carcinoid tumors. J Gastrointest Surg. 2004, 8: 742-756. 10.1016/j.gassur.2004.04.010.CrossRefPubMed
2.
Klöppel G, Perren A, Heitz PU: The gastroenteropancreatic neuroendocrine cell system and its tumors: the WHO classification. Annals of the New York Academy of Sciences. 2004, 1014: 13-27.CrossRefPubMed
3.
Ohrvall U, Eriksson B, Juhlin C, Karacagil S, Rastad J, Hellman P, Akerström G: Method for dissection of mesenteric metastases in mid-gut carcinoid tumors. World J Surg. 2000, 24: 1402-1408. 10.1007/s002680010232.CrossRefPubMed
4.
Modlin IM, Shapiro MD, Kidd M: Carcinoid tumors and fibrosis: an association with no explanation. Am J Gastroenterol. 2004, 99: 2466-2478. 10.1111/j.1572-0241.2004.40507.x.CrossRefPubMed
5.
Akerström G, Hellman P: Surgery on neuroendocrine tumours. Best Pract Res Clin Endocrinol Metab. 2007, 21: 87-109.CrossRefPubMed
6.
Kerström G, Hellman P, Hessman O: Midgut carcinoid tumours: surgical treatment and prognosis. Best Pract Res Clin Gastroenterol. 2005, 19: 717-728.CrossRefPubMed
7.
Wang Y-Z, Joseph S, Lindholm E, Lyons J, Boudreaux JP, Woltering EA: Lymphatic mapping helps to define resection margins for midgut carcinoids. Surgery. 2009, 146: 993-997. 10.1016/j.surg.2009.09.005.CrossRefPubMed
8.
Stinner B, Kisker O, Zielke A, Rothmund M: Surgical management for carcinoid tumors of small bowel, appendix, colon, and rectum. World J Surg. 1996, 20: 183-188. 10.1007/s002689900028.CrossRefPubMed
9.
Gould M, Johnson RJ: Computed tomography of abdominal carcinoid tumour. Br J Radiol. 1986, 59: 881-885. 10.1259/0007-1285-59-705-881.CrossRefPubMed
10.
Picus D, Glazer HS, Levitt RG, Husband JE: Computed tomography of abdominal carcinoid tumors. AJR Am J Roentgenol. 1984, 143: 581-584.CrossRefPubMed
11.
Druce MR, Bharwani N, Akker SA, Drake WM, Rockall A, Grossman AB: Intra-abdominal fibrosis in a recent cohort of patients with neuroendocrine ('carcinoid') tumours of the small bowel. QJM. 2010, 103: 177-185. 10.1093/qjmed/hcp191.CrossRefPubMed
12.
13.
Makridis C, Rastad J, Oberg K, Akerström G: Progression of metastases and symptom improvement from laparotomy in midgut carcinoid tumors. World J Surg. 1996, 20: 900-906. 10.1007/s002689900137. discussion 907CrossRefPubMed
14.
Akerström G, Hellman P, Hessman O, Osmak L: Management of midgut carcinoids. J Surg Oncol. 2005, 89: 161-169.CrossRefPubMed
15.
Eckhauser FE, Argenta LC, Strodel WE, Wheeler RH, Bull FE, Appelman HD, Thompson NW: Mesenteric angiopathy, intestinal gangrene, and midgut carcinoids. Surgery. 1981, 90: 720-728.PubMed
16.
Akerström G, Makridis C, Johansson H: Abdominal surgery in patients with midgut carcinoid tumors. Acta Oncol. 1991, 30: 547-553.CrossRefPubMed
17.
Chambers AJ, Pasieka JL, Dixon E, Rorstad O: The palliative benefit of aggressive surgical intervention for both hepatic and mesenteric metastases from neuroendocrine tumors. Surgery. 2008, 144: 645-651. 10.1016/j.surg.2008.06.008. discussion 651-643.CrossRefPubMed
18.
Boudreaux JP, Putty B, Frey DJ, Woltering E, Anthony L, Daly I, Ramcharan T, Lopera J, Castaneda W: Surgical treatment of advanced-stage carcinoid tumors: lessons learned. Ann Surg. 2005, 241: 839-845. 10.1097/01.sla.0000164073.08093.5d. discussion 845-836.PubMedCentralCrossRefPubMed
19.
Lai DT, Chu KM, Thompson JF, Gallagher JP, Waugh R, Storey DW, Stephen MS: Islet cell carcinoma treated by induction regional chemotherapy and radical total pancreatectomy with liver revascularization and small bowel autotransplantation. Surgery. 1996, 119: 112-114. 10.1016/S0039-6060(96)80223-6.CrossRefPubMed
20.
Tzakis AG, De Faria W, Angelis M, Verzaro R, Pinna A: Partial abdominal exenteration, ex vivo resection of a large mesenteric fibroma, and successful orthotopic intestinal autotransplantation. Surgery. 2000, 128: 486-489. 10.1067/msy.2000.107165.CrossRefPubMed
21.
Tzakis AG, Tryphonopoulos P, De Faria W, Kato T, Nishida S, Levi DM, Madariaga J, Weppler D, Mittal N, Ruiz P: Partial abdominal evisceration, ex vivo resection, and intestinal autotransplantation for the treatment of pathologic lesions of the root of the mesentery. J Am Coll Surg. 2003, 197: 770-776. 10.1016/S1072-7515(03)00756-7.CrossRefPubMed
22.
Amano H, Miura F, Toyota N, Wada K, Katoh K-I, Hayano K, Kadowaki S, Shibuya M, Maeno S, Eguchi T: In situ surgical procedures for locally advanced pancreatic cancer: partial abdominal evisceration and intestinal autotransplantation. J Hepatobiliary Pancreat Surg. 2009, 16: 771-776. 10.1007/s00534-009-0188-1.CrossRefPubMed
23.
Quintini C, Di Benedetto F, Diago T, Lauro A, Cautero N, De Ruvo N, Romano A, Di Sandro S, Ramacciato G, Pinna AD: Intestinal autotransplantation for adenocarcinoma of pancreas involving the mesenteric root: our experience and literature review. Pancreas. 2007, 34: 266-268. 10.1097/MPA.0b013e31802edee9.CrossRefPubMed
24.
Hellman P, Hessman O, Akerström G, Stålberg P, Hennings J, Björck M, Eriksson L-G: Stenting of the superior mesenteric vein in midgut carcinoid disease with large mesenteric masses. World J Surg. 2010, 34: 1373-1379. 10.1007/s00268-009-0361-3.CrossRefPubMed
Metadata
Title
Partial abdominal evisceration and intestinal autotransplantation to resect a mesenteric carcinoid tumor
Authors
William H Kitchens
Nahel Elias
Lawrence S Blaszkowsky
A Benedict Cosimi
Martin Hertl
Publication date
01-12-2011
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2011
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-9-11

Other articles of this Issue 1/2011

World Journal of Surgical Oncology 1/2011 Go to the issue

Case report

A Metachronous splenic metastases from esophageal cancer: a case report

Technical innovations

Use of a novel coaxial guide needle-wire (GNW) combination system for computed tomography guided radiofrequency tumor ablation

Case report

Cystic cavernous malformation of the cerebellopontine angle: Case report and literature review

Case report

Primary testicular necrotizing vasculitis clinically presented as neoplasm of the testicle: a case report

Case report

Alpha-fetoprotein-producing primary lung carcinoma: A case report

Review

A Review of Metallothionein Isoforms and their Role in Pathophysiology