James W Rawles III, MD, Justin Milligan, MD, Zach F Williams, MD, William W Hope, MD. New Hanover Regional Medical CenterA 56 year old AA male was diagnosed with a 2.5 cm gastric carcinoid tumor adjacent to the GE junction after workup for persistent nausea, dysphagia and abdominal pain. Subsequent EUS showed no evidence of loco-regional spread, and needle biopsy showed low grade neuroendocrine tumor c/w carcinoid. He was counseled on his surgical options including formal antrectomy vs gastric wedge resesction and periodic endoscopic surveillance. Given his compliance track record and our confidence in his willingness to follow up for surveillance EGDs, as well as his past surgical history that included a pyloromyotomy as a child, we and the patient elected to proceed with laparoscopic wedge resection alone. The patient underwent successful laparoscopic resection with intraoperative EGD. Intraoperative leak test was negative. He was admitted to the floor, started on a liquid diet on POD 1 without need for UGI contrast study, and was discharged on POD 2 tolerating a full liquid diet. Pathology revealed a 3 cm low grade carcinoid tumor with negative margins. Interestingly, the tumor pathology showed a small area of glandular atypia for which a pathologic second opinion is currently being obtained.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80581
Program Number: V116
Presentation Session: Friday Exhibit Hall Video Presentations Session 3 (Non CME)
Presentation Type: EHVideo