A case of duodenal carcinoid tumor producing gastrin in a 81-year-old woman is reported, and a brief review of the literature is presented.
The tumor was located in the anterior wall of duodenal bulb. Histologically, the tumor was a argyrophil carcinoid and resected under epidural anesthesia. Preoperative level of serum gastrin was about four-fold of normal upper limit and postoperative level was within normal limits. Furthermore, the tumor cells showed strong immuno-reactivity for gastrin. Photomicrograph of the tumor using a hematoxylin eosin stain showed a turavecular or ribbon-like structure. The tumor cells located in the muscularis mucosa and submucosal layer and had middle-sized egg-shaped nuclei. So we diagnosed the case as a carcinoid tumor producing gastrin.
Carcinoid tumor develops from the deep layer of mucosa, so preoperative diagnosis of this tumor is difficult. We could preoperatively diagnose the tumor as carcinoid tumor by typical histological pattern of bioptic specimen. The average age of these patients was about 50 years. Carcinoid tumors sometimes secrete hormone or its related substance. There have been few reports on the active substance. This case is a rare case because of demonstration of its biological activity.
