J Korean Surg Soc.  2013 Jun;84(6):367-370. 10.4174/jkss.2013.84.6.367.

Adenocarcinoma arising from Meckel's diverticulum in the ileum with malrotation of the midgut

• Lee JK
• Kwag SJ
• Oh ST
• Kim JG
• Kang WK

• KMID: 1505187
• DOI: http://doi.org/10.4174/jkss.2013.84.6.367

Abstract

Meckel's diverticulum (MD) is a true congenital diverticulum that is remnant by incomplete obliteration of the omphalomesenteric duct. It is the most common congenital anomaly of the gastrointestinal tract, with an estimated prevalence of 2% (0.3% to 3% in autopsy studies). About 90% of MD occurs within 100 cm of the ileocecal valve. A primary malignant tumor arising within an MD is extremely uncommon. Malignancies are reported to account for only 0.5% to 3.2% of the complications. Carcinoids are the most common malignant tumors occurring in MD. Adenocarcinomas are extremely uncommon and very poor prognosis has been reported. We report a case of radiographically diagnosed chronic inflammatory mass caused by adenocarcinoma arising from MD in the ileum with malrotation of the midgut incidentally discovered at exploration.

Keyword

Meckel diverticulum; Adenocarcinoma; Intestinal malrotation

MeSH Terms

Adenocarcinoma
Autopsy
Carcinoid Tumor
Diverticulum
Gastrointestinal Tract
Ileocecal Valve
Ileum
Meckel Diverticulum
Prevalence
Prognosis
Vitelline Duct

Figure

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  Fig. 1 Initial computed tomography (A, axial view) and magnetic resonance imaging (B, sagittal view) shows an approximately 6.7 cm × 6.4 cm × 6.3 cm sized chronic inflammatory mass with severe inflammatory infiltration into adjacent mesentery, sigmoid colon and small bowel loop.

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  Fig. 2 Positron emission tomography-computed tomography shows malignant tumor in pelvic cavity abutting small bowel and rectum.

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  Fig. 3 On colonoscopy, erythematous mass like external indentation on distal descending colon (A, 50 cm from anal verge) and sigmoid colon (B, 15 cm from anal verge).

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  Fig. 4 Resected specimen by laparoscopic segmental resection. Well demarcated round tan-colored firm cystic mass, measuring 6.0 cm × 4.0 cm, protruded from the serosal area.

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