Long-term disease-free survival following preoperative diagnosis and laparoscopic radical resection for Meckel's diverticulum adenocarcinoma: A case report.

BACKGROUND: Meckel's diverticulum (MD) is most commonly encountered during emergency interventions for complications or as an incidental finding during an unrelated procedure. Definitive pre-operative diagnosis of MD-associated adenocarcinoma, permitting radical resection, is very rare in clinical practice.

CASE SUMMARY: A 36-year-old male presented with recurrent dark-red hematochezia. Initial gastroscopy, colonoscopy, computed tomography, and tumor marker assessments were unremarkable. A technetium-99m pertechnetate Meckel scan (Meckel scan) revealed ectopic gastric mucosa, suggesting an MD. Double-balloon enteroscopy revealed an ulcerative stricture in the ileum, and biopsy confirmed a moderately differentiated adenocarcinoma. The patient underwent laparoscopic radical small bowel resection. Histopathology confirmed pT3N0M0, stage IIA (the American Joint Committee on Cancer 8th edition) moderately differentiated adenocarcinoma with lymphovascular invasion. Adjuvant chemotherapy was administered postoperatively. No recurrence or metastasis was observed during a 36-month follow-up.

CONCLUSION: For recurrent obscure gastrointestinal hemorrhage, combined Meckel scan and double-balloon enteroscopy is critical for diagnosing MD-associated, enabling curative resection.