LARGE CARCINOID TUMOR OF THE CECUM: CASE REPORT

Case Presentation FFS, female, 60 years old. The patient presented with a 4-year history of colicky pain associated with severe abdominal distension of a progressive nature. She developed constipation, with bowel movements every 10 days, characterized by dry stools, in addition to anorexia, asthenia, and a 13 kg weight loss over the last 2 months. Upon admission, she underwent colonoscopy, which revealed a vegetative lesion in the cecum with smooth, yellowish areas and other rough, hyperemic areas. The histopathological examination (HE) of the lesion confirmed a carcinoid tumor (neuroendocrine), without adenomas. The patient underwent laparoscopic right hemicolectomy without complications, and no metastatic foci were found. The specimen sent for histopathological analysis revealed a grade I neuroendocrine carcinoma, multifocal, with the largest focus measuring 6x3 cm, staging MpT2pN1. The patient was referred to clinical oncology for follow-up.

Discussion Carcinoid tumors are indolent neoplasms of the diffuse neuroendocrine cellular system and are typically diagnosed late. Previously considered rare, this pathology is increasingly prevalent with advancements in diagnostic technologies such as computed tomography and colonoscopy. The symptoms are nonspecific, complicating the diagnosis. Initial manifestations are often associated with subocclusive syndromes, which are related to the tumor's size and location in the gastrointestinal tract, and may progress to abdominal pain, asthenia, anorexia, and weight loss, as observed in the patient’s progression. Despite the low growth rate and metastasis rate, carcinoid tumors should be surgically resected. Tumors larger than 2 cm are rare and are often associated with lymph node and hepatic metastases, which confer a worse prognosis, making adjuvant therapy necessary.

Conclusion The patient presented with lesions that differed from the usual prevalence, with the increased size of the lesion conferring greater severity, a higher chance of metastasis, and a worse prognosis. Nevertheless, the patient had a favorable outcome during outpatient follow-up, with remission of obstructive symptoms.

Publication History

Article published online:
25 April 2025