Department of Surgery, Toyota Kosei Hospital, 500-1 Josui-cho, Toyota, Aichi 470-0396, Japan.
Jpn J Clin Oncol. 2013 Jan;43(1):74-7. doi: 10.1093/jjco/hys185. Epub 2012 Nov 6.
Carcinoid tumors located in the minor duodenal papilla are extremely rare, with only a few cases reported in the literature. Herein, we report the case of a 71-year-old man with a 12-mm carcinoid tumor at the minor duodenal papilla with lymph node metastases. Multidetector-row computed tomography with contrast enhancement revealed a 12-mm well-enhanced tumor in the duodenum. Upper gastrointestinal endoscopy showed a 12-mm submucosal tumor at the minor papilla of the duodenum. Biopsy specimens revealed a carcinoid tumor, and a subtotal stomach-preserving pancreatoduodenectomy was performed. Carcinoid tumors at the minor duodenal papilla have a high prevalence of nodal disease, even for tumors <2 cm in diameter. Therefore, we believe that radical resection with tumor-free margins (i.e. pancreatoduodenectomy) is the treatment of choice.
十二指肠小乳头的类癌肿瘤极为罕见,文献中仅报道了少数几例。在此,我们报告了 1 例 71 岁男性,十二指肠小乳头有 12mm 大小的类癌肿瘤,并伴有淋巴结转移。多排螺旋 CT 增强扫描显示十二指肠内有 12mm 大小的强化肿瘤。上消化道内镜检查显示十二指肠小乳头有 12mm 大小的黏膜下肿瘤。活检标本显示为类癌肿瘤,行保留胃的胰十二指肠切除术。即使肿瘤直径<2cm,十二指肠小乳头的类癌肿瘤也有很高的淋巴结疾病发生率。因此,我们认为根治性切除且切缘无肿瘤(即胰十二指肠切除术)是首选的治疗方法。