Endoscopic Management of a Primary Duodenal Carcinoid TumorAbraham A. · Singh J. · Siddiqui G. · Prasad A. · Rashid S. · Vardaros M. · Garg V. · Rizvon K. · Subramani K. · Mustacchia P.
Department of Internal Medicine, Nassau University Medical Center, East Meadow, N.Y., USA
Carcinoids are rare, slow-growing tumors originating from a variety of different neuroendocrine cell types. They are identified histologically by their affinity for silver salts and by positive reactions to neuroendocrine markers such as neuron-specific enolase, synaptophysin and chromogranin. They can present with various clinical symptoms and are difficult to diagnose. We present the case of a 43-year-old woman who was referred for evaluation of anemia. Upper endoscopy showed a duodenal bulb mass around 1 cm in size. Histopathological and immunohistochemistry staining were consistent with the diagnosis of a carcinoid tumor. Further imaging and endoscopic studies showed no other synchronous carcinoid lesions. Endoscopic ultrasound (EUS) revealed a 1 cm lesion confined to the mucosa and no local lymphadenopathy. Successful endoscopic mucosal resection of the mass was performed. Follow-up surveillance 6 months later with EUS and Octreoscan revealed no new lesions suggestive of recurrence. No consensus guidelines exist for the endoscopic management of duodenal carcinoid tumors. However, endoscopic resection is safe and preferred for tumors measuring 1 cm or less with no evidence of invasion of the muscularis layer.
Department of Internal Medicine, Nassau University Medical Center
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Published online: March 23, 2012
Number of Print Pages : 8
Number of Figures : 3, Number of Tables : 1,
Case Reports in Gastroenterology
Vol. 6, No. 1, Year 2012 (Cover Date: January - April)
Journal Editor: Urrutia R. (Rochester, Minn.), Lomberk G. (Rochester, Minn.)
ISSN: 1662-0631 (Print), eISSN: 1662-0631 (Online)
For additional information: http://www.karger.com/CRG