LETTER TO THE EDITOR
Adult transmural intestinal ganglioneuromatosis is not always associated with multiple endocrine neoplasia or neurofibromatosis: a case report
1 Department of Surgery, Bristol Royal Infirmary, Bristol, UK
2 Department of Clinical Pathology, Bristol Royal Infirmary, Bristol, UK
3 Colorectal Unit, Bristol Royal Infirmary, Bristol, UK
Correspondence to:
Correspondence to:
Dr S F Ledwidge
Department of Surgery, Bristol Royal Infirmary, Marlborough Street, Bristol BS2 8HW, UK; sledwidge@doctors.org.uk
Accepted 26 April 2006
| The first 150 words of the full text of this article appear below. |
A 45-year-old woman presented with a 6-week history of anorexia, diarrhoea and weight loss. Barium enema examination showed a stricturing lesion in the caecum consistent with the radiological features of a colonic carcinoma. A computed tomography scan of the abdomen confirmed the presence of circumferential mural thickening of the caecum, with extensive surrounding pericolic infiltration. There was no evidence of metastasis.
At laparotomy, there was a palpable caecal mass extending to the ileocaecal valve which was adherent to the right pelvic side wall and to the proximal transverse colon. An extended right hemicolectomy was performed.
The surgical specimen contained an annular mass in the caecum (fig 1
), extending to the terminal ileum. There was no luminal surface ulceration of the lesion. Histological examination showed a diffuse infiltration of the muscularis propria by fine nerve fibres and larger nerve bundles occasionally accompanied by ganglia, with frequent extension into the submucosa
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