A Case of Carcinoid at the Papilla of Vater Accompanied by Cholecystolithiasis

Abstract

A 73-year-old female was admitted with a complaint of right upper abdominal pain. Ultrasonography showed dilatation of the biliary tract, the pancreatic duct, and cholecystolithiasis. On endoscopic examination, a protruding lesion like submucosal tumor with redness was noted at the papilla of Vater. The biopsy specimens taken from the surface of the tumor showed only inflammation.
But, under the diagnosis of carcinoma of the Vater, a pancreatoduodenectomy was performed. On resection, the tumor was 4×3.5×3 cm in size. Tumor invasion was observed from the submucosa to proper muscle layer of the duodenum. And there were three stones in the gallbladder. No metastasis was detected at lymph node and any other regions. Histologically, the tumor was diagnosed as carcinoid. The argyrophil reaction stained by Grimelius method showed positive.
Carcinoid at the papilla of Vater is a very rare disease and only 30 cases have been reported in Japan, and the one with cholecystolithiasis is very rare being limited to only 2 cases.