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Peritoneal metastases from malignant degeneration of ectopic gastric epithelium in Meckel's diverticulum: A case

Ehab El Bahesh1, Bruce M Abell2, Paul H Sugarbaker3

  • 1Division of Hematology and Oncology, George Washington University Cancer Center, Washington DC, USA.

International Journal of Surgery Case Reports
|August 11, 2019
PubMed
Abstract

Insights

This case study details a rare instance of adenocarcinoma in a Meckel's diverticulum. Multidisciplinary treatment, including chemotherapy, led to a complete response and no recurrence in a patient with peritoneal metastases.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Medical Oncology

Background:

  • Meckel's diverticulum is a common congenital gastrointestinal anomaly.
  • Ectopic gastric or pancreatic tissue within the diverticulum can undergo malignant transformation.
  • Adenocarcinoma arising from Meckel's diverticulum is exceptionally rare.

Purpose of the Study:

  • To report a case of peritoneal metastases from adenocarcinoma in a Meckel's diverticulum.
  • To describe the multidisciplinary treatment approach and outcomes.

Main Methods:

  • Diagnosis confirmed via surgical resection of the affected small bowel segment.
  • Systemic chemotherapy administered using a multiagent regimen (oxaliplatin, mitomycin C, doxorubicin, capecitabine - O-Max).
  • Second-look surgery performed to assess response to chemotherapy.

Main Results:

  • The patient presented with acute abdominal pain and peritoneal metastases.
  • The O-Max chemotherapy regimen achieved significant clinical and radiologic response.
  • Extensive tissue sampling after chemotherapy confirmed a complete response with no evidence of recurrence at four years.

Conclusions:

  • Peritoneal metastases from malignant degeneration of ectopic gastric epithelium in Meckel's diverticulum can be successfully treated.
  • A multidisciplinary treatment strategy, including systemic chemotherapy, is beneficial for managing this rare condition.
Keywords:
Complete remissionMeckel diverticulumMetastatic adenocarcinomaO-MAX chemotherapy

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