Abstract
A patient with duodenal carcinoid is reported on, especially findings of endoscopic ultrasonography (EUS).
A 63-year-old man was pointed out having an elevated lesion in the duodenal bulb at the medical check-up. Endoscopy at this time revealed a submucosal tumor with smooth surface and elevated reddness, but biopsy showed negative results. Then 18 months later endoscopy showed ulceration on the top, and biopsy of this site revealed carcinoid. He was admitted to the hospital for operation. Endoscopy showed a Yamada III type elevated lesion (10 mm in diameter) in the anterior wall of the duodenal bulb accompanied by an ulcer at the elevated lesion. EUS visualized a tumor as a relatively homogeneous hypoechoic mass with irregular margines, suggesting no invasion to the proper muscle layer. Based on these findings, a diagnosis of carcinoid localized in the submucosal layer was made. Subtotal gastrectomy with R2 lymphnode dissection was performed. Histological examination also showed localization of the tumor within the submucosal layer. EUS may be useful for preoperative evaluation of carcinoids to determine the appropriate treatment.
