A case of primary duodenal NET that recurred 17 years later as multiple liver metastases and obstructive jaundice

Abstract

A woman in her 70s visited our hospital complained of her jaundice. She had a history of pyloric gastrectomy, extended left hepatic lobectomy, and Billroth-II reconstruction 17 years ago due to hepatic metastasis of a duodenal tumor initially diagnosed with duodenal adenocarcinoid. Enhanced CT scan showed multiple intrahepatic tumors and a hypervascularized tumor in the pancreatic head caused obstructive jaundice. By performing cholangiography using a double-balloon endoscopy, a plastic stent was implanted in stenosed common bile duct and successfully improved her jaundice. Percutaneous biopsy of the hepatic tumor subsequently revealed tissue similar to that of resected tumor 17 years ago. In addition to the immunostaining results, we concluded the diagnosis of recurrence of duodenal NET. NETs are known to recur at a high rate even after curative resection, but cases of recurrence more than 10 years after curative resection are comparatively rare. Therefore, we reported this case here with a discussion of the literature.