1995 Volume 56 Issue 5 Pages 994-998
The choice of operative methods experienced in four cases of duodenal carcinoid tumor is reported. Case 1 involved a 53-year-old woman. The preoperative diagnosis was hyperplastic polyp. Partial resection of the duodenum was performed. The post-operative course was uneventful. Case 2 involved a 47-year-old man. The preoperative diagnosis was Zollinger-Ellison syndrome. Pancreaticoduodenectomy was performed. Regional lymph nodes were involved. he is now alive, but has a liver metastasis. Case 3 involved a 51-year-old man. The preoperative diagnosis was duodenal polyp. Partial resection of the duodenum was performed. Regional lymph nodes were involved. The patient is strictly followed for nerwly detected lymph node metastasis. Case 4 involved a 69-year-old man. The preoperative diagnosis was duodenal carcinoid tumor. Partial resection of the duodenum was performed. The post-operative couurse was uneventful. In a review of 89 cases of carcinoid tumor including these four cases, the relation between the tumor size and histological vertical invasion and metastasis was investigated. It is concluded that pancreaticoduodenectomy should be performed, if the tumor diameter is more than 20mm or the histologic invasion is greater than pm level the metastatic rate starts to increase. It is also necessary to mobilize the duodenum and explore lymph node metastasis, even with partial resection of the duodenum.
