Carcinoid tumor metastatic to neck

Area of Science:

• Oncology
• Gastroenterology
• Surgical Pathology

Background:

• Carcinoid tumors are rare neuroendocrine neoplasms.
• Metastasis of carcinoid tumors to cervical lymph nodes is exceptionally uncommon.
• Initial misdiagnosis of neck mass as adenocarcinoma highlights diagnostic challenges.

Purpose of the Study:

• To document a unique case of carcinoid tumor metastasis to the anterior triangle of the neck.
• To discuss the diagnostic and management implications of this rare presentation.
• To emphasize the importance of considering carcinoid tumors in the differential diagnosis of neck masses.

Main Methods:

• Clinical presentation of a 50-year-old woman with a neck mass.
• Diagnostic workup including needle biopsy and subsequent radical excision of cervical lymph nodes.
• Identification of metastatic adenocarcinoma suggestive of carcinoid tumor.
• Investigation of primary tumor in the terminal ileum and mesenteric lymph nodes.
• Surgical resection of all visible tumor.

Main Results:

• Initial needle biopsy misinterpreted as undifferentiated adenocarcinoma.
• Cervical lymph node dissection revealed metastatic adenocarcinoma, suspicious for carcinoid tumor.
• Abdominal mass identified as mesenteric lymph nodes involved by carcinoid tumor, originating from the terminal ileum.
• Patient remained symptom-free and clinically well for 15 months post-resection.
• No prior documented cases of carcinoid tumor metastasis to the neck were found in the literature.

Conclusions:

• This case represents the first reported instance of carcinoid tumor metastasis to the neck.
• Accurate pathological diagnosis is crucial for appropriate management of metastatic neuroendocrine tumors.
• Surgical resection offers a viable treatment option for localized metastatic carcinoid disease.
• Further research into the patterns of carcinoid tumor metastasis is warranted.