Peritoneal metastases from malignant degeneration of ectopic gastric epithelium in Meckel's diverticulum: A case report.

BACKGROUND: Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, resulting from incomplete obliteration of the omphalomesenteric duct in early fetal development. The diverticulum frequently contains ectopic gastrointestinal epithelial tissue, most commonly gastric or pancreatic. Adenocarcinoma can arise from either of these epithelia but is extremely rare, with less than 50 cases reported in the world literature.

METHODS: In a patient with peritoneal metastases from ectopic gastric mucosae in a Meckel's diverticulum a multidisciplinary treatment plan was initiated.

RESULTS: Diagnosis was evident from study of the resected specimen of small bowel in a patient with acute abdominal pain. A multiagent chemotherapy regimen using oxaliplatin, mitomycin C, doxorubicin, and capecitabine (O-Max) resulted in a clinical and radiologic response. A second surgery with extensive sampling of tissues from the abdomen and pelvis confirmed a complete response to systemic chemotherapy. At four years from onset of disease the patient has no evidence of recurrence.

CONCLUSIONS: Peritoneal metastases from malignant degeneration of ectopic gastric epithelium in a Meckel's diverticulum was reported. Multidisciplinary treatments were beneficial.