Abstract
A 47-year-old man was seen at the hospital because of abnormal findings of the duodenum pointed out at a medical checkup. Upper gastrointestinal endoscopy showed a protruded lesion with the diameter of 15 mm and a shallow concave at the center. With a biopsy, carcinoid tumor was diagnosed. On an ultrasonographic endoscopy, the depth of tumor invasion was thought to be “sm”. No hepatic metastasis and periduodenal lymph node swelling were visualized on an abdominal CT scan. A pylorus preserving pancreatoduodenectomy was performed with a diagnosis of a carcinoid tumor of the accessory papilla Vater of the duodenum. Histopathologically, it was a 14×13 mm carcinoid tumor of the accessory papilla Vater of the duodenum, with the tumor invasion depth of “sm”, and three positive nodes were present at the lymph node 14d.
Since there are some cases of carcinoid tumor of the accessory papilla Vater of the duodenum with positive lymph nodes compared to a small diameter of the tumor like in this case, radical surgery with lesional lymph node dissection like pancreatoduodenectomy would be desirable.
