A 40-year-old man is found to have a 1.5 cm well-differentiated neuroendocrine tumor in the mid-ileum during staging workup. What is the most appropriate surgical management?
- A Local wedge resection of the involved bowel segment
- B Wide local excision with segmental resection and removal of the draining mesenteric lymph nodes ✓
- C Right hemicolectomy with ileocolic artery ligation
- D Endoscopic mucosal resection as the tumor is under 2 cm
Correct answer: B. Wide local excision with segmental resection and removal of the draining mesenteric lymph nodes
Explanation
Small bowel neuroendocrine tumors, regardless of size, have significant metastatic potential to regional mesenteric lymph nodes. The standard surgical management is segmental bowel resection with wide mesenteric lymph node dissection. Unlike appendiceal NETs under 2 cm (where appendectomy alone suffices), small bowel NETs require formal oncologic resection due to higher nodal metastasis rates.
Reference: Cameron's Current Surgical Therapy, 14th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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