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Open Access Technical innovations

Partial abdominal evisceration and intestinal autotransplantation to resect a mesenteric carcinoid tumor

William H Kitchens1, Nahel Elias2, Lawrence S Blaszkowsky3, A Benedict Cosimi2 and Martin Hertl2*

Author Affiliations

1 Department of Surgery, Massachusetts General Hospital, Boston, MA, USA

2 Transplantation Unit, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA

3 Massachusetts General Hospital Cancer Center, Boston, MA, USA

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World Journal of Surgical Oncology 2011, 9:11  doi:10.1186/1477-7819-9-11

Published: 31 January 2011

Abstract

Background

Midgut carcinoids are neuroendocrine tumors that commonly metastasize to the intestinal mesentery, where they predispose to intestinal obstruction, ischemia and/or congestion. Because of their location, many mesenteric carcinoid tumors are deemed unresectable due to the risk of uncontrollable bleeding and prolonged intestinal ischemia.

Case Presentation

We report the case of a 60-year-old male with a mesenteric carcinoid tumor obstructing his superior mesenteric vein, resulting in intestinal varices and severe recurrent GI bleeds. While his tumor was thought to be unresectable by conventional techniques, it was successfully resected using intestinal autotransplantation to safely gain access to the tumor. This case is the first described application of this technique to carcinoid tumors.

Conclusions

Intestinal autotransplantation can be utilized to safely resect mesenteric carcinoid tumors from patients who were not previously thought to be surgical candidates. We review the literature concerning both carcinoid metastases to the intestinal mesentery and the use of intestinal autotransplantation to treat lesions involving the mesenteric root.