Abstract
We experienced a case of carcinoid tumor of the duodenal papilla.
A 43-year-old woman was admitted to the hospital because of upper abdominal pain. Ultrasonography and CT visualized a remarkable dilatation of intrahepatic bile duct. PTC revealed a V-shaped complete occlusion at the terminal portion of the common bile duct. Endoscopically the Vater papilla significantly swelled. Biospy of the mucosa which partially changed to a red hue indicated Group V (adenocarcinoma). So the patient was diagnosed as having a cancer of the duodenal papilla, and pancreatoduodenectomy was carried out. Histopathologically the typical cells grew in the papilla limitedly; and no deep invasion nor lymph node metastasis was observed. As to immunohistochemical staining, the specimen showed positive for NSE and chromogranine A. The diagnosis of carcinoid tumor was made.
A review of the literature in this country suggests that the tumor tends to progress toward the submucosal layer. It means that the tumor often presents difficulty in preoperative diagnosis. It is thought that pancreatoduodenectomy with sufficient lymph node dissection is an appropriate operative procedure.
