MULTIPLE DUODENAL CARCINOID TUMORS -A CASE REPORT-

Abstract

Many cases of duodenal carcinoid reported previously have involved solitary and single lesions, and duodenal carcinoid accounts for only 4.5% of all duodenal tumors. Multicentric duodenal carcinoid lesions are very rare. We report the case of a 65-year-old man who underwent partial duodenectomy and distal gastrectomy for multiple duodenal carcinoids. An upper gastroduodenal series in a general screening examination at an affiliated hospital revealed a slight abnormality in the stomach. Endoscopic examination detected a polypoid lesion (Yamada-I type) in the bulb of the duodenum, and the histological diagnosis of the biopsy specimen was duodenal carcinoid. Endoscopic mucosal resection (EMR) was performed in our hospital, and the specimen was histologically diagnosed as primary duodenal carcinoid. A week later, another lesion was found close to the EMR scar during a follow-up endoscopic examination, and partial duodenectomy and distal gastrectomy were performed a month later. Pathological examination of the whole resected specimen revealed scattered multicentric duodenal carcinoid lesions, and immunohistochemical analysis showed that each lesion had quite different characteristics. Our experience in this case shows the importance of careful endoscopic analysis for multicentricity in case of duodenal carcinoid.