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Case Reports
. 2025 May 23;17(5):e84661.
doi: 10.7759/cureus.84661. eCollection 2025 May.

Atypical Presentation of Small Bowel Neuroendocrine Carcinoma Leading to Acute Obstruction

Aravind Kumar  1 , V Ramlakshmi  1 , Samir Ahmad  1 , Alexander Mecheri Antony  1
Affiliations
Case Reports

Atypical Presentation of Small Bowel Neuroendocrine Carcinoma Leading to Acute Obstruction

Aravind Kumar et al. Cureus. .

Abstract

Rare neoplasms called neuroendocrine tumors (NETs) develop from intestinal enterochromaffin cells. They commonly produce symptoms through the secretion of serotonin along with other vasoactive peptides, resulting in carcinoid syndrome, characterized by cutaneous flushing and diarrhea. NETs are a very aggressive type of cancer, for which prognostic factors are lacking. They are also rarely found in males and young adults. Carcinoid tumors make up an atypical and intricate disease spectrum with various clinical features. The combination of etoposide and carboplatin can enhance overall survival in complex WHO stage 3 neuroendocrine carcinoma with regional lymph node involvement and a generally poor prognosis. However, in the absence of distant metastasis and with a relatively fair performance index, this treatment may be more effective. In this instance, we report a neuroendocrine tumor case that presented unusually as an acute intestinal obstruction. The patient had resection and anastomosis of the small bowel of the affected region along with the surrounding mesentery.

Keywords: acute intestinal obstruction; carcinoid syndrome; gasterointesinal tract; neuro endocrine tumor; neuroendocrine carcinoma(nec).

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. X-ray erect abdomen showing multiple dilated bowel loops suggestive of small bowel obstruction
In small bowel obstruction, the centrally positioned gas-filled and distended bowel loops (marked by yellow arrows) are noted. The white lines traversing the full width of the bowel are valvulae conniventes (marked by red arrows), which are characteristic of the small bowel.
Figure 2
Figure 2. Resected segment of congested and edematous small bowel showing two polyps (noted with arrows)
The polyps, each measuring approximately 2 × 2 × 1 cm, were located about 20 cm proximal to the ileocecal junction (ICJ). The surrounding bowel loops were congested and edematous, with cicatrized mesentery and a stricture in the ileum at the same level.
Figure 3
Figure 3. Resection and anastomosis of the small bowel of the affected region of the bowel along with the surrounding mesentry
The affected segment of the bowel was resected along with the mesentery, and end-to-end anastomosis was performed.
Figure 4
Figure 4. Neuroendocrine tumor histopathology showing monotonous cells with round to oval nuclei and finely speckled “salt and pepper” chromatin
No mitotic activity is observed in this case.
See this image and copyright information in PMC

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