Abstract
Two cases of duodenal carcinoid were presented. Case 1: A 47-year-old woman entered Yamada hospital with the chief complaint of epigastralgia. Physical examination revealed epigastric tenderness. Although serum serotonin and urine 5-HIAA were normal, serum gastrin were elevated. A gastrointestinal series and endoscopic finding showed small polypoid lesion in the duodenal bulb. Strip biopsy were performed and biopsy specimen proved carcinoid cells. The tumor, measuring 4×7×7mm in size, was removed by surgical operation. The tumor was located at the duodenal submucosa. Gastrin were not proved in the tumor and serum gastrin after operation were still high. Case 2 : A-73-year-old woman who hoped gastrointestinal examination consulted a doctor although she had no gastrointestinal symptome. Physical examination revealed almost no abnormality. Endoscopic examination showed semi-pedunculated polyp in the duodenal bulb. The tumor, measuring 5×10mm in size, was removed by endoscopic polypectomy. The tumor was located at the duodenal lamina propria. The histological patterns of the both tumor were those of classical pattern of carcinoid tumor, composing of small uniforms with trabecular and pseudorozett structures. Car-cinoid cells were stained by the Glimelius method. Approximately 145 cases of duodenal carcinoid tumors have been reported in Japan, but 24 of them had been diagnosed definitely with endoscopic biopsy, polypectomy or strip biopsy. Gastric carcinoid tumors with hypergastrinemia were often reported, but reports of duodenal carcinoid tumor associated with hypergastrinemia were only 6 cases including our case. All of them except one case were not shown gastrin in the duodenal tumors. However our case showed atrophic gastritis on the biopsy speciemen. It is suggested that duodenal carcinoid tumor with hypergastrinemia were accompanied with type A chronic gastritis. We discussed indication of polypectomy of duodenal carcinoids.
