부산대학교 도서관

A 67-year-old man who visited a neighboring hospital because of abdominal pain and high fever in November 2014 was diagnosed with acute cholecystitis and treated conservatively. In December of the year, he developed jaundice in addition to abdominal pain and fever. After consulting the neighboring hospital, he was referred to the Department of Medicine in our hospital for the purpose of close exploration, and then he was admitted to our department with a diagnosis of cancer of the inferior bile duct. In January 2015 pancreatoduodenectomy was performed. During surgery, we identified a diverticulum associated with a tumor in the ileum 20-cm proximal to the ileum end and a 5-cm diameter tumor at the mesentery around the diverticulum. Associated resection of these lesions was performed. Histopathological studies disclosed that the tumor in the diverticulum was a carcinoid tumor in Meckel's diverticulum (NET, G1) and the mesenteric tumor was its lymph node metastasis. Only inflammatory thickening of the wall was observed in the bile duct. Meckel's diverticulum is found in about 1-2 % of all autopsy cases and the frequency of tumors arising in Meckel's diverticula has been reported to be 1-4 %. Reported tumors arising in Meckel's diverticula include gastrointestinal stromal tumor (GIST), adenocarcinoma and leiomyoma. So far only three cases of carcinoid tumor have been reported in Japan.