Carcinoid Tumor in Accidental, Asymptomatic Meckel's Diverticulum
A 75-year-old female patient had a history of appendicectomy. Following blunt abdominal injury she was admitted due to lack of bowel movements, abdominal cramps, pain, distension and vomiting. Ileus of the small bowels was established as the underlying cause of her complaints and urgent operation was performed. During abdominal exploration adhesions were found on an approximately, 15 cm section of the terminal ileum and adhesiolysis was carried out. During the operation, Meckel's diverticulum without any sign of inflammation was found and wedge excision was performed. No ectopic tissue could be palpated intraoperatively. Patient passed a smooth post-operative period and the bowel movements returned post-operatively and she was discharged with no complaints.\nPathological work-up of the resected Meckel's diverticulum revealed ectopic tissue in addition to the small bowel, mucosa and gastric glands were found. However, a well-circumscribed lesion of 0.5 cm was also detected that was well-distinguishable from the adjacent tissues. It infiltrated the muscle layer of the bowel, but no further layers were involved. The round, cuboidal cells built up nests and fascicles in the involved area. The nuclei were centrally located the chromatin was finely granulated. Immunohistochemical studies were also performed that proved the suspected diagnosis of carcinoid tumor. They were positive for synaptophysin, but negative for chromogranine, cytokeratin (CK) 7 and CK20. No vascular or lymphatic invasion was found and no abnormal lymph node could be detected. The final diagnosis was neuroendocrine carcinoma of Meckel's diverticulum based on the pathological finding []. Patient has been followed-up by oncologists since the operation.