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Published on: July 21, 2023
Intestinal adenocarcinoma originating from an undiagnosed Meckel's diverticulum
Daniel R Principe1, Peter Nesper2, Anastasia E Metropulos3
1Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA.
Abstract:
Meckel's diverticulum is a congenital anomaly leading to the formation of a true diverticulum in the distal small intestine. Though most are asymptomatic and discovered incidentally, Meckel's diverticuli can give rise to a wide range of symptoms. Rarely, this can be a malignancy, most commonly a carcinoid tumor. Other cancers have also been reported, with adenocarcinomas being particularly rare. Here, we report the case of a 62-year-old man presenting to the emergency room with vague gastrointestinal symptoms. Subsequent workup revealed a 3 cm mass in the distal jejunum/proximal ileum, which was located within a previously undiagnosed Meckel's diverticulum. The mass was sent to pathology, who confirmed an adenocarcinoma arising from a small bowel diverticulum. This case serves as an important reminder of the malignant potential of a Meckel's diverticulum and adds to the ongoing discussion regarding whether prophylactic diverticulectomy should be recommended to patients with a known Meckel's diverticulum.
Insights
A rare adenocarcinoma was found in a Meckel's diverticulum, a congenital small intestine anomaly. This case highlights the potential for malignancy in these diverticula and informs decisions about prophylactic surgery.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Pathology
Background:
- Meckel's diverticulum is a common congenital anomaly of the small intestine.
- Most Meckel's diverticula are asymptomatic but can cause complications.
- Malignancies within Meckel's diverticula are rare, with carcinoid tumors being most common.
Observation:
- A 62-year-old male presented with vague gastrointestinal symptoms.
- Imaging revealed a 3 cm mass within an undiagnosed Meckel's diverticulum in the distal jejunum/proximal ileum.
- Pathology confirmed the mass as an adenocarcinoma.
Findings:
- Adenocarcinoma arising within a Meckel's diverticulum is an exceptionally rare finding.
- This case underscores the malignant potential of Meckel's diverticula beyond carcinoid tumors.
- The diagnosis was made in a patient presenting with non-specific gastrointestinal symptoms.
Implications:
- This case contributes to the discussion on the necessity of prophylactic diverticulectomy for incidentally discovered Meckel's diverticula.
- Awareness of rare malignant transformations in Meckel's diverticulum is crucial for timely diagnosis and management.
- Further research may clarify optimal management strategies for asymptomatic Meckel's diverticula with malignant potential.
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