Carcinoid of the Caecum with Osseous and Soft Tissue Metastases: A Rare Case Report 1098-1100
C/o, Mr. Narayan Mohapatra
Pithapur Main Road, Cuttack - 753001
Background: The carcinoid tumour arises from the enterochromaffin cells of Kulchitsky at the base of the crypts of Leiberkuhn. Gastrointestinal (GI) carcinoids account for 95 % of all the carcinoids and caecal carcinoids account for 5 % of all the carcinoids. They remain silent and asymptomatic for years and many a times, are diagnosed intraoperatively, endoscopically or during autopsy, based on their histopathological findings. Malignant carcinoids metastasise to the liver and the lymph nodes, while bone and soft tissue metastasis have rarely been reported. We present here, a rare case of caecal carcinoid with bone and soft tissue metastasis.
Case Report: A 47 year old female was admitted with pain in the abdomen in our hospital, 3 years back. Colonoscopy showed caecal pathology, for which resection and anastomosis was done. Her post operative histopathology revealed carcinoidof the caecum which invaded the subserosa with lymph node metastasis. She received adjuvant chemotherapy and presented to the OPD 3 years later, with swellings over the medial end of the right clavicle, the anterior chest wall and the node on the right side of the neck. FNAC from all these sites revealed metastatic carcinoid. She was treated with chemotherapy and palliative radiotherapy and has been asymptomatic for the past two years.
Conclusion: Carcinoids are slow growing, indolent tumours and they may remain asymptomatic for years. Malignant carcinoids rarely metastasise to the bone and soft tissues. The present report adds to the literature, an interesting case of caecal carcinoid with osseous and soft tissue metastasis, besides highlighting the importance of histopathology in its diagnosis, as well as the role of chemotherapy and palliative radiotherapy in controlling the symptoms.