Retrograde lymphatic metastasis of an ileal carcinoid

Carcinoid tumors are uncommon tumors, derived from Kulchitsky cells, which generally follow a slow, orderly metastatic spread. They are often associated with second primary malignant neoplasms either synchronously or metachronously.

A 62 year old white female with a history of severe dysplasia of the vulva and carcinoid of the distal ileum presented with a presumed vulvar malignancy by biopsy from a referring hospital. She did not have symptoms of the carcinoid syndrome. Wide vulvar excision revealed chronic inflammation without residual tumor. Bilateral superficial and deep inguinal lymphadenectomy revealed metastatic carcinoid.

The inguinal lymph nodes should be considered a site of distant metastasis for carcinoid tumors of the distal ileum.