Neuroendocrine tumors arising in Meckel's diverticula: frequency of advanced disease warrants aggressive management

Allison W Lorenzen, Thomas M O'Dorisio, James R Howe
Journal of Gastrointestinal Surgery 2013, 17 (6): 1084-91

BACKGROUND: Meckel's diverticulum is a common anomaly of the GI tract, which occasionally gives rise to cancer. The most frequent tumors affecting these diverticula are neuroendocrine tumors (NETs), and whether these should be treated in similar fashion as small bowel NETs or appendiceal NETs is unclear.

METHODS: A retrospective chart review was conducted at a single academic medical center between 1998 and 2012. Demographic, radiologic, biochemical, and clinicopathologic data were collected as well as status at last follow-up.

RESULTS: Seven patients were identified with NETs involving Meckel's diverticula, including one with limited information other than management of her late metastases. Of the six other patients, all had involvement of regional nodes, including three patients with tumors <2 cm in size, and four had liver metastases at presentation.

CONCLUSIONS: NETs in Meckel's diverticula are rare tumors, but when they develop, are often associated with nodal metastases and liver metastases, even when the tumors are small. Therefore, optimal management of these NETs is small bowel resection with regional lymphadenectomy and debulking of liver metastases where feasible.

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